Associate Director, Data Strategist

Brillio • New York, NY

27d

About The Position

Data Strategist – Pharmacy Benefit ________________________________________ Overview We are seeking a highly skilled Data Strategist with deep experience in the Pharmacy Benefit Management (PBM) domain and strong expertise across transactional and analytical data stores, both on cloud and on-prem. This role enables data-driven transformation across PBM operations by bridging business teams, product teams, and engineering. The ideal candidate combines PBM domain understanding with strong strategic data architecture literacy—particularly across Mainframe/legacy adjudication systems, Teradata, Postgres, and Databricks. ________________________________________ Key Responsibilities 1. Strategic Data Leadership • Develop end-to-end data strategy across PBM functional areas (claims adjudication, formulary, PA/UM, specialty, clinical programs, network operations). • Translate business goals into data capabilities, including transactional readiness, analytical models, and AI/insight enablement. • Define the North Star architecture centered on: o Databricks for analytics & AI enablement o Postgres for modern operational/transactional workloads o Teradata as the existing enterprise analytical backbone o Mainframe–based adjudication and operational systems 2. Business–Technology Bridge • Drive alignment between business leads, pharmacy operations, product management, data engineering, and architecture teams. • Capture and refine data requirements tied to real PBM workflows and regulatory needs. • Create clear data documentation: canonical models, lineage, definitions, integration patterns, domain mappings. 3. Data Architecture & Modeling • Guide design of transactional data structures (claims, member, provider, formulary, PA, specialty). • Partner with engineering to shape analytical datasets in Teradata and Databricks for cost, quality, adherence, and operational insights. • Shape migration paths from legacy/mainframe data to modern analytical or operational stores. 4. Governance & Quality • Establish governance models around ownership, metadata, critical data elements, and stewardship. • Lead data quality and observability initiatives across PBM domains. • Ensure compliance with PHI rules, HIPAA, and audit expectations. 5. Product & AI Enablement • Enable analytics and AI use cases such as: o Real-time PA insights o Cost optimization / formulary alignment o Fraud, Waste, Abuse o Adherence prediction & member targeting o Pharmacist enablement & specialty workflows • Support product teams in defining data-driven roadmaps and measurable value outcomes.

Requirements

• 7–12+ years of experience in healthcare with 4–5+ years in PBM or specialty pharmacy.
• Strong familiarity with PBM data domains: o NCPDP claims o Formulary & benefit design o PA/UM data o Network & pharmacy data o Specialty/hub workflows o Rebate & financial/reconciliation data
• Ability to work across mainframe, Teradata, Postgres, and Databricks ecosystems.
• Strong SQL proficiency and experience guiding data modeling conversations.
• Experience collaborating with product, engineering, business operations, and compliance.

Nice To Haves

• Experience modernizing PBM data & analytics ecosystems.
• Familiarity with ML/AI enablement on Databricks.
• Knowledge of NCPDP, HL7, FHIR standards.
• Experience working in fast-paced consulting or digital product environments.

Responsibilities

• Develop end-to-end data strategy across PBM functional areas (claims adjudication, formulary, PA/UM, specialty, clinical programs, network operations).
• Translate business goals into data capabilities, including transactional readiness, analytical models, and AI/insight enablement.
• Define the North Star architecture centered on: o Databricks for analytics & AI enablement o Postgres for modern operational/transactional workloads o Teradata as the existing enterprise analytical backbone o Mainframe–based adjudication and operational systems
• Drive alignment between business leads, pharmacy operations, product management, data engineering, and architecture teams.
• Capture and refine data requirements tied to real PBM workflows and regulatory needs.
• Create clear data documentation: canonical models, lineage, definitions, integration patterns, domain mappings.
• Guide design of transactional data structures (claims, member, provider, formulary, PA, specialty).
• Partner with engineering to shape analytical datasets in Teradata and Databricks for cost, quality, adherence, and operational insights.
• Shape migration paths from legacy/mainframe data to modern analytical or operational stores.
• Establish governance models around ownership, metadata, critical data elements, and stewardship.
• Lead data quality and observability initiatives across PBM domains.
• Ensure compliance with PHI rules, HIPAA, and audit expectations.
• Enable analytics and AI use cases such as: o Real-time PA insights o Cost optimization / formulary alignment o Fraud, Waste, Abuse o Adherence prediction & member targeting o Pharmacist enablement & specialty workflows
• Support product teams in defining data-driven roadmaps and measurable value outcomes.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed
• Number of Employees: 5,001-10,000 employees