Director, Clinical Pharmacy Operations & Policy

Cambia Health Solutions; Burlington (WA); Hybrid; USD 168,000 - 275,000; Full time

Benefits offered by this job

Health benefits

401(k) with company match

Paid time off

Parental leave

Wellness programs

Job summary

Cambia Health Solutions is seeking a Director of Clinical Operations and Medical Policy to lead clinical pharmacy activities, formulary development, and policy across commercial, Medicare, and marketplace lines. The role blends clinical pharmacy leadership with health policy and utilization management in a mission-driven, multi-state environment.

The position requires strong leadership, strategic thinking, and collaboration with internal teams and external partners.

Qualifications

• Bachelor's degree in Pharmacy or PharmD; residency preferred
• Minimum of five years of management or professional business experience in a managed health care system or equivalent
• Licensed pharmacist in state of practice

Responsibilities

• Lead and direct clinical pharmacy services aligned with strategic goals, managing nearly $2B in annual drug expense
• Provide vision and leadership to the Clinical Pharmacy Services team, overseeing budgets and change management
• Direct formulary, medication policy, prior authorization, and utilization management activities across lines of business
• Be accountable for P&T Committee, MPG, and related governance committees, including Medicare and QHP formularies
• Direct and oversee medication use programs to optimize value and manage pharmacy trend drivers
• Collaborate across internal and external teams to optimize programs supporting medication access, quality, and affordability
• Ensure ongoing evaluation and quality improvement of evidence-based medication technology assessment methods
• Engage with peers to lead a mission-driven organization and drive impact

Skills

Pharmacy leadership

Clinical pharmacy

Regulatory compliance

Budget management

Leadership and mentoring

Education

PharmD or Bachelor of Pharmacy

Residency or advanced degree in health care administration/economics/public health/pharmacy administration/finance

Tools

P&T strategy tools

Job description

Cambia Health Solutions is seeking a Director of Clinical Operations and Medical Policy to lead clinical pharmacy activities, formulary development, and policy across commercial, Medicare, and marketplace lines. The role blends clinical pharmacy leadership with health policy and utilization management in a mission-driven, multi-state environment.

The position requires strong leadership, strategic thinking, and collaboration with internal teams and external partners.