Medicare Pharmacy Programs Manager, II, or Sr DOE

About the role

Cambia is seeking a Medicare Pharmacy Program Manager, II, or Sr. to join our hybrid role (3 days/week in office) at various locations including Burlington, Renton, Spokane, Vancouver, Portland, Medford, Salt Lake City, Boise, Lewiston, or Fargo. Candidates must reside within commutable distance of the location or be willing to relocate.

Responsibilities

• Represent Pharmacy Services in Medicare business relationships in partnership and on behalf of the Pharmacy Leadership Team.
• Establish and lead pharmacy programs for Medicare program governance and workstream meetings to enhance Medicare Advantage and Medicare Part D program offerings.
• Develop and maintain the pharmacy portfolio or products, projects, and initiatives to support the full scope of Government Programs for pharmacy benefit management work and activities.
• Create and maintain reporting functions and key performance indicators.
• Share status updates and value generation strategies and progress across all areas of Pharmacy to support Medicare Advantage programs.
• Represent and advocate for resource needs and organizational support on Medicare programs and initiatives – all in service of creating a person-focused health care experience.

Requirements

Qualifications:

• Bachelor's Degree in Business, Health Care Administration, or related field (Masters preferred)
• Minimum 5+ years' experience with project and/or program management in healthcare, healthcare insurance operations or other large, complex industry
• Experience in clinical area preferred

Skills and Attributes:

• Ability to think analytically, effectively applying project management and financial techniques, and providing recommendations to management using critical thinking and sound judgment
• Ability to coordinate cross-functionally with all levels of the organization for the purpose of driving solutions and resolving issues in a timely and effective manner
• Proficiency in effectively managing high-profile projects and reporting barriers to program deliverables
• Strong analytical skills, with the ability to analyze complex data and situations, learn quickly and create options, recommendations and action plans
• Ability to resolve issues and build consensus among groups of diverse stakeholders
• Experience in independently defining, developing, managing and reporting on processes and metrics
• Ability to accomplish results through others by establishing relationships, effective controls and monitoring processes
• Ability to partner effectively with external partners/vendors
• Familiarity with health plan and clinical terminology, operations and trends
• Experience with AI tools and technologies to enhance productivity and decision-making in professional settings highly desire

Benefits

Pay ranges vary based on the candidate's work location. The expected hiring range depends on skills, experience, education, and training; relevant licensure / certifications; and performance history. Program Manager positions in Oregon, Washington, Utah, and Idaho have an expected hiring range of $92,700 - $184,000, with a full salary range of $87,000 - $208,000 and a bonus target of 15%. North Dakota positions have an expected hiring range of $90,906.79 - $173,372.75, with a full salary range of $80,716.23 - $187,737.35 and a bonus target of 15%.

Qualifications

• Bachelor's Degree in Business, Health Care Administration, or related field (Masters preferred)
• Minimum 5+ years' experience with project and/or program management in healthcare, healthcare insurance operations or other large, complex industry
• Experience in clinical area preferred

Skills and Attributes

• Ability to think analytically, effectively applying project management and financial techniques, and providing recommendations to management using critical thinking and sound judgment
• Ability to coordinate cross-functionally with all levels of the organization for the purpose of driving solutions and resolving issues in a timely and effective manner
• Proficiency in effectively managing high-profile projects and reporting barriers to program deliverables
• Strong analytical skills, with the ability to analyze complex data and situations, learn quickly and create options, recommendations and action plans
• Ability to resolve issues and build consensus among groups of diverse stakeholders
• Experience in independently defining, developing, managing and reporting on processes and metrics
• Ability to accomplish results through others by establishing relationships, effective controls and monitoring processes
• Ability to partner effectively with external partners/vendors
• Familiarity with health plan and clinical terminology, operations and trends
• Experience with AI tools and technologies to enhance productivity and decision-making in professional settings highly desire