Manager Clinical Pharmacy Quality and Affordability Programs

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

Who We Are Looking For

Every day, Cambia’s dedicated team of Pharmacy leaders are living our mission to make health care easier and lives better. As a member of the Pharmacy Service leadership team, our Manager Clinical Pharmacy Quality and Affordability Programs manages a team of clinical pharmacists. Organizes, and oversees clinical pharmacy program development, implementation, and maintenance of clinical drug safety, quality, and affordability programs across all lines of business.

The scope includes medications covered under the pharmacy benefit, medical benefit and specialty medications – all in service of creating a person-focused health care experience.

As a people leader, you are willing to learn and grow, understanding that leadership is a craft that is continuously honed as you support your team and the lives that depend upon us.

Are you energized by building and mentoring high-performing teams of clinical pharmacists who are passionate about quality and patient safety? Do you want your leadership to matter beyond the bottom line—where clinical excellence, health equity, and making health care easier are the measures of success? Then this role may be the perfect fit.

Qualifications

What You Bring to Cambia:

• Bachelor's degree in Pharmacy or Pharm.
  
  D;
  Residency certificate or advanced degree in health care administration, economics, public health, pharmacy administration, finance, or equivalent field preferred
• Minimum 3 years of experience in patient care setting as well as management or professional business experience in a managed health care system, medical group, hospital, or related business in health care delivery industry or an equivalent combination of education and experience
• Licensed pharmacist in state of practice

Skills And Attributes

• Strong clinical pharmacy background with ability to demonstrate clinical therapy skills and knowledge.
• Strong business acumen, knowledge of health care economics and financing, health care and PBM industry dynamics, benefit design, provider contracting strategies, techniques, and operational processes.
• Demonstrated success in managing matrixed professional business relationships in a managed care system, medical group, hospital, or related business in health care delivery industry.
• Excellent verbal and written communication skills; strong business analytical skills and abilities; project management and coordination ability; ability to function effectively as a management team member.
• Demonstrated ability to review and analyze data from medication claims, recommending programs and policies to encourage appropriate utilization.
• Ability to select, train and lead staff, manage resources and prioritize workload.
• Demonstrated knowledge of:
  Medicare/CMS regulations and applicability in administering the Medicare Product;
  Pharmaceutical products, including orals, injectables, infusion products, and chemotherapy;
  Health care coding and payment systems (such as ICD-10, CPT, HCPCS, NDC);
  Compliance related activities, legislative and regulatory activities; state and federal laws and rules regarding the practice of pharmacy and regulation of health care industry practices, such as DOLI, PPACA and HIPAA.
• Experience with AI tools and technologies to enhance productivity and decision-making in professional settings highly desired

What You Will Do At Cambia

• Prioritizes and manages the implementation, and maintenance of clinical pharmacy programs, including (but not limited to) Stars, HEDIS, eValu8, and other clinical safety, quality, and affordability programs which encourages the use of the best value medications, discourage use of unsafe medications or those with limited clinical value.
• Leads, and collaborate with, departmental and cross-organizational teams and committees (including clinical services, customer…