Pharmacy Program Manager

About the role

Join our Cause to create a person-focused and economically sustainable health care system. As a member of the Pharmacy Services team, our Pharmacy Program Managers are responsible for partnering with clinical stakeholders to develop, execute, evaluate and maintain clinical programs and strategies to support cost containment and clinical quality improvements related to pharmacy.

Responsibilities

• Own and manage the full lifecycle of assigned clinical programs, including serving as subject matter expert, maintaining policies and procedures, monitoring processes and outcomes, making data-driven decisions, and ensuring initiatives are delivered on time and meet expectations.
• Analyze and evaluate program metrics, dashboards, and clinical product offerings on a regular basis to maintain a competitive portfolio, demonstrate strong ROI, and apply expert healthcare knowledge to improve outcomes in quality, cost, and member experience.
• Lead project management responsibilities including task assignments, monitoring compliance with due dates, and overseeing company-wide or enterprise-wide programs and projects that impact multiple business units.
• Partner with clinical stakeholders, vendors, and cross-functional departments to accomplish program goals, promote integration of clinical services, and deliver a holistic member experience, including negotiating and managing vendor performance and inter-departmental coordination.
• Serve as a consultative resource and Cambia representative for strategic partners, plan leadership, purchasers, pharmacy partners, and other internal and external stakeholders, facilitating communication and ensuring alignment of strategic goals.
• Collaborate with analysts and business partners to develop meaningful dashboards and presentations that inform and influence business strategies, including at the senior leadership level, combining business knowledge with program evaluation methodologies.
• Provide thought leadership, practical guidance, and mentorship to junior team members while taking initiative on broadly scoped projects and contributing to strategy development, program implementation, and continuous improvement across the organization.

Qualifications

• Bachelor's degree
• 8+ years of experience in the health care industry with a focus on pharmacy and prescription drug benefit administration, or equivalent combination of education and experience
• Project management experience and clinical degree or certification preferred

Skills and Attributes

• Deep knowledge of pharmacy benefit management, benefit design, pharmacy products and services, competitive offerings, and client needs, including advanced understanding of healthcare operations, cost containment strategies, provider contracting methodologies, and benefit design alternatives.
• Proficiency in claims processing systems (Facets preferred), MS Office products, and other corporate software.
• Strong analytical, research, and data interpretation skills with the ability to synthesize literature, clinical input, expert opinion, policy, and analytic insights to develop innovative solutions and drive strategy.
• Demonstrated program development skills including setting goals, identifying and engaging stakeholders, establishing milestones, and driving measurable outcomes.
• Expert ability to lead full project cycles from ideation through evaluation, managing company-wide programs and cross-functional teams across diverse areas of the organization.
• Exceptional facilitation, presentation, and communication skills with the ability to resolve issues and build consensus among diverse internal and external stakeholders, including leadership.
• Strong business acumen with the ability to align recommendations and solutions to organizational goals and expected outcomes.
• Able to organize, prioritize, and manage multiple projects simultaneously within time constraints, including the ability to work effectively under pressure.
• Able to coordinate activities across all levels of colleagues and external business partners through clear and concise verbal and written communication.
• Demonstrated success leading cross-functional teams and contributors toward shared goals in a complex, matrixed environment.
• Experience with AI tools and technologies to enhance productivity and decision-making in professional settings highly desired.

Pay

The expected hiring range for a Pharmacy Program Manager is $101,200 - $136,900 depending on skills, experience, education, and training; relevant licensure / certifications; and performance history. The bonus target for this position is 15%. The current full salary range for this role is $95,000 - $155,000.