PBM RFP & Pricing Lead - Remote

OneDigital

15d•$110,000 - $150,000•Remote

About The Position

OneDigital is seeking a highly experienced PBM RFP & Pricing Lead to own and enhance their end-to-end pharmacy RFP process. This is a hands-on, strategic role focused on product ownership of the RFP process, pricing model development, and PBM financial evaluation. This role reports to and partners closely with the Director of PBM Performance, taking strategic direction while owning execution, process development, and advancement of the RFP function. The ideal candidate brings deep expertise in PBM underwriting, pricing mechanics, and bid evaluation, with the ability to translate complex financial proposals into clear, actionable insights. This individual will play a critical role in building scalable processes, improving modeling capabilities, and leveraging AI-driven solutions to modernize and accelerate the RFP lifecycle. This role will also provide mentorship and help support the development and growth of the RFP function.

Requirements

5–10+ years of experience in PBM consulting, underwriting, pricing, or RFP strategy
Deep understanding of PBM financial models, including: AWP discounts, MAC pricing, and ingredient cost structures, Rebate guarantees (PMPM, per-claim, hybrid models), Specialty pharmacy economics and trend drivers, Administrative fees and contract financial terms
Experience building and/or evaluating PBM RFPs and bidder responses
Advanced Excel skills required
Strong analytical and problem-solving skills with high attention to detail
Ability to translate complex data into clear, executive-level insights
Self-starter who thrives in a build/scale environment

Nice To Haves

experience with SQL, data tools (Qlik, Power BI, Tableau), or RFP platforms is a strong plus
Exposure to AI tools, automation, or data product development (or strong interest in applying AI to business processes)

Responsibilities

Own and continuously improve the end-to-end PBM RFP process, from strategy and development through evaluation and finalist selection
Standardize RFP structures, question sets, and evaluation methodologies across clients
Identify opportunities to streamline workflows and implement tools/technology to increase efficiency and scalability
Mentor & lead junior team members and help build and mature the RFP team’s capabilities
Lead development and refinement of PBM pricing models (discount guarantees, rebate structures, admin fees, specialty pricing, etc.)
Evaluate and normalize bidder financial proposals to enable true “apples-to-apples” comparisons
Analyze key drivers of cost (ingredient cost, utilization, rebates, clinical programs) and identify risk/opportunity areas
Validate underwriting assumptions and challenge PBM pricing methodologies
Translate complex PBM proposals into clear financial and strategic insights for internal teams and clients
Identify pricing risks, hidden fees, and contractual nuances that impact total cost of care
Support finalist negotiations by providing data-driven recommendations and scenario modeling
Act as a “product owner” for RFP tools, models, and analytics (Excel-based, SQL-driven, or platform-based solutions)
Assist in the design, development, and implementation of AI-driven capabilities to enhance the RFP process, including: Automated extraction of PBM contract terms and pricing components, AI-assisted summarization and comparison of bidder responses, Predictive modeling and benchmarking of PBM pricing outcomes
Partner with analytics and engineering resources to translate RFP workflows into scalable systems and tools
Continuously identify opportunities to leverage AI and automation to reduce manual effort, improve accuracy, and increase speed
Work closely with audit, analytics, and consulting teams to align RFP outputs with downstream audit and monitoring strategies
Support business development efforts by contributing to proposals and client presentations
Serve as a subject matter expert on PBM pricing and market dynamics