Medicare Pharmacy Programs Manager, II, or Sr DOE

Medicare Pharmacy Program Manager

Hybrid role (3 days/week in office) at our Burlington, Renton, Spokane, Vancouver, Portland, Medford, Salt Lake City, Boise, Lewiston, or Fargo offices.

Candidates must reside within commutable distance of that location or be willing to relocate.

Build a career with purpose. Join our Cause to create a person-focused and economically sustainable health care system.

Every day, Cambia's dedicated team of Program Managers are living our mission to make health care easier and lives better. As a member of the Pharmacy Services team, our Medicare Pharmacy Program Manager will 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.

Ready to shape the future of Medicare pharmacy programs that impact millions of lives? What if your expertise in pharmacy program management could drive meaningful change in how people experience health care? Then this role may be the perfect fit.

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. May have equivalent combination of education and experience

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.

• Work closely with project sponsor(s), cross-functional teams, and project managers to plan and develop scope, deliverables, required resources, work plan, budget, and timing for new initiatives.
• Effectively manage internal/external stakeholder relationships, ensuring the focused pursuit of desired outcomes.
• Manage program and project teams to identify risks and opportunities across multiple initiatives or work streams to ensure program goals are reached.
• Educate and train the leadership, staff, business associates and other stakeholders regarding new program elements, process and implementation.
• Maintain a system for ongoing data/statistical reporting and program assessment. Develop and communicate program documents, project plans, etc.
• Effectively collaborate with internal program leaders, senior management, and…