FIND YOUR CONSULTANT
JOIN OUR COMMUNITY
FIND YOUR CONSULTANT
JOIN OUR COMMUNITY

Industries > 

Healthcare > Retail & Specialty Pharmacy Practice

Retail & Specialty Pharmacy Practice

Umbrex connects healthcare product retailers and specialty pharmacies to independent consultants with deep experience in the industry.

Over 90% of our Retail & Specialty Pharmacy Practice consultants are alums of McKinsey, Bain, or BCG.

Finding the right consultant should be this easy.

1

Tell us about your project

2

Interview candidates

(We’ll provide bios within 48 hours on average)

3

Select your consultant and start work!

Find a consultant in our Retail & Specialty Pharmacy Practice

Prefer email? Write to [email protected]

Client Segments Umbrex Serves

  • National & Regional Retail Chain Pharmacies: Large drugstore, grocery, and mass-merchant pharmacy operators expanding clinical services, omnichannel and mail-order fulfillment, payer contracting, 340B programs, while optimizing front-store and central-fill economics.
  • Independent & Small-Chain Community Pharmacies: Independent pharmacies and mini-chains improving payer mix, PSAO leverage, adherence and immunization programs, local marketing, 340B contract pharmacy execution, and pharmacy-to-front-store profitability.
  • Independent Specialty Pharmacies: Non-payer, non-hospital specialty pharmacies securing limited-distribution access, payer coverage, accreditations, outcomes reporting, REMS compliance, and integrated hub partnerships to grow high-cost therapy volumes.
  • Long-Term Care Pharmacies: Closed-door pharmacies serving SNFs and seniors housing, optimizing med-pass packaging, consultant pharmacist services, eMAR integration, delivery logistics, payer contracting, and survey readiness.
  • Home & Alternate-Site Infusion Pharmacies: Infusion pharmacies providing sterile compounding, home nursing coordination, and infusion suites; improving referral pipelines, reimbursement, USP 797/800 compliance, inventory turns, and cold-chain distribution.”

Selected Capabilities of our Retail & Specialty Pharmacy Practice

Strategy & Corporate Development

  • Enterprise Growth And Market Entry Strategy: Define where to play across retail, specialty, mail, and infusion; quantify demand, competitive intensity, and site-of-care shifts to prioritize geographic expansion and formats.
  • Specialty Pharmacy Build Buy Partner Strategy: Evaluate greenfield, acquisition, and joint venture pathways; prioritize therapeutic areas and biosimilars; build business cases and roadmaps to secure payer and manufacturer access.
  • Mergers And Acquisitions Target Screening And Diligence: Build pipeline and screening; run commercial and operational diligence on scripts, payer mix, limited distribution drugs (LDD), and EBITDA; define synergy cases and integration theses.
  • Manufacturer And Limited Distribution Access Strategy: Craft manufacturer value proposition, outcomes reporting, data services, and patient support models to win limited distribution drugs and exclusive network participation.
  • Network And Channel Strategy: Prioritize pharmacy benefit manager (PBM) preferred networks, narrow networks, integrated delivery network partnerships, and referral channels to expand covered lives, grow specialty scripts, improve economics.

Operations

  • End-To-End Dispensing Workflow Redesign: Redesign intake, data entry, fill, verification, and pickup using queuing, batching, and automation to cut wait time, reduce rework, and increase prescriptions per labor hour.
  • Central Fill And Micro Fulfillment Operating Model: Design and scale central fill and micro fulfillment allocation, tote flows, and SLAs to shift stable scripts from stores, lower labor cost, and improve predictability.
  • Staffing Model And Labor Productivity: Build demand-driven staffing models, role mix, and scheduling templates; set productivity standards and labor routines to reduce overtime, improve coverage, and increase prescriptions per hour.
  • Specialty Patient Onboarding And Time To Therapy: Streamline benefits investigation, prior authorization, financial assistance, Risk Evaluation and Mitigation Strategy (REMS) coordination, and onboarding to reduce time to therapy, abandonment, and referral fallout.
  • Tech Check Tech And Verification Model: Implement tech-check-tech under state scope, remote image verification, and work segmentation to free pharmacist time for immunizations, clinical services, and consults while maintaining accuracy.

Supply Chain

  • Network Design And Distribution Strategy: Optimize pharmacy distribution network across wholesalers, specialty hubs, DCs, and stores; define ship-from rules and delivery frequency to reduce logistics cost and raise fill rate.
  • Inventory Optimization And Replenishment: Build demand forecasting, safety stock, reorder points, and vendor-managed inventory to reduce stockouts, expiries, and working capital while stabilizing service levels across retail and specialty.
  • Cold Chain And High-Value Drug Handling: Design packaging, data loggers, lane qualification, and last-mile protocols to protect cold chain, controlled substances, and limited distribution drugs, reducing excursions, spoilage, and shrink.
  • DSCSA Serialization And Traceability Enablement: Implement Drug Supply Chain Security Act (DSCSA) serialization, verification, and serialized data exchange to enable interoperable traceability, reduce quarantine backlogs, and prevent dispense delays.
  • Shortage Response And Allocation Management: Build shortage playbooks, fair-share allocation rules, and cross-store redistribution processes to maintain service levels for specialty and injectables during supply disruptions.

Procurement & Strategic Sourcing

  • Wholesaler Contract Strategy And Negotiation: Optimize primary and secondary wholesaler agreements covering brand cost-minus, generic programs, service fees, returns, price protection, and fill rates to lower COGS and improve margin.
  • Generic Sourcing And Reverse Auctions: Run multi-round RFPs and reverse auctions for generics; set formularies and Wholesale Acquisition Cost (WAC) ceilings to capture price declines and ensure supply continuity.
  • Specialty Distribution And Hub Services Sourcing: Source and negotiate specialty distributor and hub contracts with access terms, interfaces, service level agreements, and per-script fees to reduce acquisition cost and time-to-therapy.
  • Indirect Spend And Packaging Category Sourcing: Source vials, labels, personal protective equipment (PPE), cold-chain packaging, refrigeration, and store supplies; consolidate vendors and leverage volume to lower unit cost and reduce stockouts.
  • Automation And Technology Procurement: Lead RFPs and negotiations for central fill automation, dispensing robots, and verification tech; optimize pricing, warranties, and service terms to lower labor and maintenance cost.

Organization

  • Enterprise Operating Model And Organization Design: Define operating model across retail, specialty, mail, central fill, and call centers; align structure, spans and layers, and role charters to improve accountability and scalability.
  • Governance And Decision Rights: Establish enterprise governance, quality and controlled-substance councils, and decision rights for services, technology, and compliance to accelerate decisions, reduce risk, and ensure consistent execution.
  • Workforce Architecture And Role Taxonomy: Define role taxonomy, competencies, and career paths for pharmacists, technicians, patient access coordinators, and specialty liaisons to improve capability building, retention, and internal mobility.
  • Incentive Compensation And Performance Management: Design incentive plans and scorecards aligned to prescriptions per labor hour, clinical services, adherence, time to therapy, safety, and patient experience to drive balanced performance.
  • Shared Services And Center Of Excellence Design: Stand up centralized prior authorization, benefits investigation, patient financial assistance, and analytics centers of excellence to reduce time to therapy, improve conversion, and standardize outcomes.

Marketing & Patient Engagement

  • Omnichannel Patient Acquisition And SEO: Deploy targeted campaigns across search, social, and email; optimize SEO and listings to drive new scripts, immunizations, and clinic visits at lower cost per acquisition.
  • Prescriber Marketing And Referral Development: Create provider marketing, field liaison playbooks, and digital portals to increase specialty referrals, e-prescribe capture, and therapy initiations from priority prescribers.
  • Adherence And Refill Engagement Program Design: Build segmentation-driven outreach using SMS, apps, interactive voice response (IVR), and med sync; increase refill rate, persistence, and proportion of days covered while reducing abandonment.
  • Patient Experience And Journey Design: Map end-to-end patient journeys; set service standards, proactive communications, and closed-loop feedback to raise Net Promoter Score and reduce complaints, transfers, and churn.
  • Loyalty And Membership Strategy: Design loyalty programs, rewards, and subscription offerings; integrate personalized offers and pricing to improve retention, refill frequency, basket size, and lifetime value.

Pricing

  • Prescription Cash Pricing And U&C Management: Redesign cash price files, usual and customary (U&C) logic, NADAC-based floors, and discount card routing to protect reimbursement, prevent underpayment, and grow profitable self-pay scripts.
  • Zone-Based Prescription Pricing And Competitor Indexing: Set zone strategies and competitor indexes for cash prices by molecule, strength, and dosage form to improve price perception while safeguarding margin and compliance.
  • Specialty Service Fee And Program Pricing: Price specialty patient management, adherence, clinical programs, and outcomes reporting for manufacturers and payers; define per-script and per-patient fees linked to service levels and results.
  • Clinical Services And Immunization Pricing: Design pricing for immunizations, point-of-care testing, clinical consults, and delivery; align to payer fee schedules and local willingness-to-pay to maximize adoption and margin.
  • Compounding And Specialty Preparation Pricing: Build cost-plus pricing for compounded medications and specialty preparations using ingredient cost, labor standards, and overhead rates to ensure profitability and transparent patient quotes.

Finance & Reimbursement

  • Third-Party Claims And Underpayment Recovery: Build NCPDP claim edit governance and variance analytics; recover PBM underpayments, MAC discrepancies, generic effective rate and brand effective rate variances via disputes, resubmissions.
  • DIR Fee Forecasting And Accruals: Model direct and indirect remuneration fees and PBM performance fees; build month-end accruals, settlement tracking, and forecast impact on script margin, EBITDA, and cash flow.
  • PBM Remittance And Reconciliation Optimization: Standardize PBM remittance ingestion, cash application, and short-pay resolution; automate reconciliation to NCPDP claims and wholesaler invoices to reduce write-offs and improve cash predictability.
  • Gross-To-Net And Script Margin Analytics: Build gross-to-net engine incorporating acquisition cost, rebates, generic and brand effective rates, DIR fees, and shrink; deliver script margin and mix insights for portfolio decisions.
  • FP&A And Store-Level Performance Management: Stand up pharmacy financial planning and analysis, budgets, forecasts, and variance reviews; enable store P&L visibility, labor and inventory dashboards to identify levers improving EBITDA.

AI, Data & Analytics

  • Enterprise Data Platform And Governance: Build Health Insurance Portability and Accountability Act compliant pharmacy data platform integrating dispensing, claims, remittances, and specialty hub data; establish governance and quality for analytics.
  • Nonadherence Prediction And Next-Best Action: Use machine learning to predict nonadherence and abandonment; trigger SMS, med sync, refill reminders, pharmacist outreach to lift proportion of days covered and persistence.
  • Specialty Time To Therapy Analytics: Analyze onboarding bottlenecks across benefits investigation, prior authorization, and Risk Evaluation and Mitigation Strategy requirements; predict delays and prioritize worklists to reduce time to therapy.
  • Diversion And Controlled Substance Risk Analytics: Detect patient and prescriber shopping, abnormal fill patterns, and inventory shrink using anomaly detection; generate case queues to reduce loss, fines, and regulatory exposure.
  • Generative Intake And Prior Authorization Automation: Apply optical character recognition, natural language processing, and generative AI to classify faxes, extract data, and draft prior authorizations; cut touch, cycle time, and errors.

Transformation

  • Transformation Office And Value Realization: Stand up a Transformation Management Office to prioritize initiatives, track benefits, remove roadblocks, and enforce accountability across retail, specialty, mail, central fill.
  • Enterprise Margin Turnaround And Cost Takeout: Deliver EBITDA improvement through labor productivity, centralization, automation, logistics optimization, generic mix, shrink reduction, and overhead rationalization while protecting service, safety, and compliance.
  • Store Portfolio Optimization And Format Transformation: Redesign store footprint and formats using geospatial demand, script density, and clinic potential; close, relocate, or convert to micro-fulfillment and service-led formats to lift returns.
  • Post-Merger Integration And Synergy Delivery: Lead integrations to capture synergies from overhead consolidation, wholesaler harmonization, central fill adoption, network rationalization, and IT convergence; secure Day 1 continuity and value capture.
  • Change Management And Frontline Adoption: Build change story, training, incentives, and coaching for pharmacists and technicians; drive durable adoption of new workflows, technology, and performance routines across the enterprise.

Innovation

  • New Service Incubation And Test-And-Learn: Build innovation funnel, design sprints, stage gates, and pilot playbooks to rapidly test, validate, and scale new retail and specialty pharmacy offerings.
  • Digital Health And Virtual Pharmacist Care Design: Design telepharmacy, asynchronous consults, digital therapeutics support, and remote MTM models; define workflows, reimbursement, and technology to expand access and adherence.
  • Clinical Services Expansion And Minor Ailments: Develop CLIA-waived testing, Test-to-Treat, immunizations, women’s health, travel, and minor ailments prescribing; build protocols, training, and economics to drive profitable service growth.
  • Manufacturer And Payer Solutions Co-Development: Co-develop adherence programs, outcomes reporting, real-world evidence, and patient support services with manufacturers and payers to secure limited distribution access and incremental specialty revenue.
  • Decentralized Clinical Trials Enablement: Design pharmacy-based decentralized clinical trials capabilities including screening, recruitment, specimen collection, and data capture; meet Good Clinical Practice standards to unlock sponsor partnerships and revenue.

Regulatory & Accreditation

  • Specialty Accreditation Strategy And Readiness: Prepare for URAC, ACHC, and The Joint Commission specialty accreditation through gap assessments, SOPs, QMS, outcomes reporting, and audits to secure payer and manufacturer access.
  • Multistate Licensure And Expansion Enablement: Plan and execute Board of Pharmacy licensure, nonresident permits, telepharmacy approvals, and responsible pharmacist coverage to accelerate market entry and maintain compliance across jurisdictions.
  • Controlled Substance Regulatory Compliance Program: Design Drug Enforcement Administration compliance for controlled substance ordering, Form 222, perpetual inventory, federal reporting, suspicious order monitoring, and audit readiness to mitigate diversion risk.
  • Compounding Standards Readiness: Achieve United States Pharmacopeia , , compliance through facility design, environmental monitoring, SOPs, competencies, and certification to reduce citations, contamination risk, and interruptions.
  • Risk Evaluation And Mitigation Strategy Compliance Enablement: Build Risk Evaluation and Mitigation Strategy programs with prescriber/pharmacy certification, patient enrollment, documentation, and audits to enable restricted therapy dispensing and reduce noncompliance risk.

Program & Portfolio Management

  • Enterprise Portfolio Prioritization And Stage Gate: Prioritize cross-enterprise initiatives across retail, specialty, mail, and central fill; set business cases, stage gates, and funding to maximize ROI and strategic impact.
  • Program Governance And Steering Cadence: Establish PMO governance, decision rights, and executive steering routines; unblock dependencies and accelerate on-time, on-budget delivery of store, specialty, and technology programs.
  • Benefits Realization And KPI Tracking: Set baselines, OKRs, and KPIs; deploy dashboards and variance reviews to verify value capture across prescriptions per labor hour, time to therapy, margin, and adherence.
  • Resource And Capacity Management: Model project and subject-matter-expert capacity; sequence work, balance field deployment bandwidth, and optimize vendor utilization to de-risk timelines and accelerate critical initiative milestones.
  • Deployment Factory And Field Readiness: Build deployment playbooks, training, and cutover plans; run wave planning and command centers to deliver consistent, low-disruption rollouts across stores, central fill, and specialty.

Information Technology

  • Pharmacy Systems Architecture And Modernization: Modernize pharmacy management, verification, POS, IVR, and central fill orchestration; adopt APIs and microservices to increase throughput, resilience, and upgrade velocity.
  • Interoperability And Standards Integration: Implement NCPDP SCRIPT 2017071, electronic prior authorization, EPCS, and real-time benefit check; build PBM, prescriber, and hub APIs to reduce errors and rework.
  • Omnichannel Patient Platform Integration: Integrate apps, web, SMS, and IVR with dispensing systems for refills, delivery scheduling, and notifications, cutting abandonment, inbound calls, and wait times.
  • Specialty Connectivity And Case Orchestration: Integrate specialty hubs, payer portals, REMS systems, and ePA to automate document exchange and status updates, accelerating benefits investigation and prior authorization cycle time.
  • Cybersecurity, Privacy, And Compliance Hardening: Deploy zero-trust network access, multi-factor authentication, logging, and endpoint protection; meet HIPAA, DEA, and PCI DSS requirements to protect PHI and dispensing uptime.

Capital Projects

  • Capex Planning And Prioritization: Develop multi-year capex portfolio and investment cases for store remodels, clinics, central fill, and automation; prioritize by ROI, payback, risk, and strategic growth.
  • Store Remodel And Format Conversion Program: Design standards and prototypes for pharmacy remodels, drive-thru, consultation rooms, and clinic co-location; manage permitting, vendor bids, schedules, and commissioning to minimize downtime.
  • Central Fill And Micro Fulfillment Commissioning: Design facility layout, mechanical, electrical, and plumbing systems with conveyor and automated storage; run throughput tests and ramp plans to de-risk central fill and micro-fulfillment.
  • Compounding Cleanroom And Hazardous Drug Facility Design: Design USP and compliant cleanrooms, negative pressure, airflow, and monitoring; manage certification, commissioning, and policy alignment to enable sterile and hazardous compounding.
  • Cold Chain And Refrigeration Infrastructure Upgrades: Engineer pharmacy cold chain with redundant refrigeration, backup power, temperature monitoring, and alerting; deliver layouts and commissioning to reduce excursions, spoilage, and high-cost drug loss.

Payer Contracting & PBM Relations

  • PBM Contract Strategy And Negotiation: Build negotiation strategy and redlines for generic effective rate, brand effective rate, MAC, specialty fees; model scenarios to improve reimbursement and reduce concessions.
  • Performance Program And Price Concession Optimization: Analyze PBM performance metrics and direct and indirect remuneration (DIR) mechanics; design levers to improve adherence, outcomes, and scores, minimizing fees and maximizing incentive payments.
  • Audit Readiness And Dispute Management: Build PBM audit defense playbooks, documentation standards, and pre-bill controls; design dispute governance and analytics to reduce takebacks, recoupments, and chargebacks.
  • Medical Benefit Contracting For Specialty Therapies: Negotiate medical-benefit rates, coverage policies, site-of-care shifts, and prior authorization alignment for infusion and clinician-administered therapies to expand access and improve economics.
  • Payer Clinical Services Contracting: Secure payer contracts for Medication Therapy Management (MTM), immunizations, point-of-care testing, and minor ailments prescribing; define measurement, documentation, and reimbursement terms to scale clinical services.

340B Program Management

  • 340B Contract Pharmacy Strategy And Network Design: Design 340B contract pharmacy network with covered entities; model capture and margin, manage manufacturer restrictions, set fees and service levels to maximize compliant value.
  • TPA Integration And Accumulator Optimization: Implement and optimize third-party administrator accumulators; integrate dispensing, prescriber, and eligibility data; improve match rates, replenishment accuracy, and cycle time across stores and specialty.
  • HRSA Audit Readiness And Compliance Monitoring: Build 340B policies, self-audits, and monitoring; prevent diversion and duplicate discounts via Medicaid Exclusion File alignment and state identifiers; maintain OPAIS and execute corrective actions.
  • Financial Reconciliation And Settlement Design: Standardize covered entity–pharmacy reconciliation, invoice and credit files, dispense fee and share calculations; improve transparency, dispute resolution, and cash flow predictability across contract pharmacy partnerships.
  • Referral Capture And Eligibility Governance: Operationalize referral capture with provider affiliation documentation, location eligibility, and audit trails; lift eligible script capture while meeting 340B documentation requirements across specialty and retail.

Quality & Patient Safety

  • Enterprise Pharmacy Quality Management System: Establish a Quality Management System (QMS), councils, policies, audits, and scorecards to improve dispensing accuracy, immunization safety, and specialty outcomes; align with URAC, ACHC, and board expectations.
  • Medication Safety And Error Reduction: Implement bar code verification, Tall Man lettering, independent double checks, and near-miss capture to reduce wrong-drug, wrong-dose, and labeling errors across retail and central fill.
  • Continuous Quality Improvement And RCA: Stand up quality improvement and root cause analysis (RCA) for incidents and complaints; trend hazards, implement corrective actions, and verify effectiveness to cut repeats.
  • Compounding Quality Control And Environmental Monitoring: Build sterility assurance program with media fills, personnel competencies, surface/air sampling, and excursion investigations to maintain control state and reduce contamination and batch failures.
  • Vaccine Safety And Cold Chain Quality Assurance: Standardize vaccine administration protocols, screening, anaphylaxis readiness, and temperature monitoring with excursion management to prevent adverse events, wastage, and CDC Vaccines for Children citation risk.

Connect with the right consultant

Umbrex rapidly connects you with independent professionals who combine top‑tier consulting experience at firms such as McKinsey, Bain, Boston Consulting Group with hands‑on roles.

Find a consultant in our Retail & Specialty Pharmacy Practice

Prefer email? Write to [email protected]

Thought Leadership

Industry Insights from Umbrex:
How to analyze a Healthcare Provider

How to Analyze a Healthcare Provider