Director, Clinical Pharmacy Ops & Policy — Hybrid Leader

Cambia Health Solutions; Vancouver (WA); Hybrid; USD 179,000 - 243,000; Full time

Benefits offered by this job

Medical, dental and vision

401(k) with company match

Paid time off

Parental leave

Job summary

Cambia Health Solutions in Vancouver, WA is seeking a Director of Clinical Operations and Medical Policy to direct clinical pharmacy activities, formulary management, and policy development across multiple benefit lines. You will lead a team, oversee governance committees, and drive utilization management and medication policy with impact on members nationwide.

The role requires strategic leadership, strong clinical pharmacy background, and expertise in health economics, policy, and regulatory

Qualifications

• Bachelor's degree in Pharmacy or PharmD with licensure; residency/advanced degree preferred.
• Minimum five years in management or professional business experience in a managed health care system or related field.
• Licensed pharmacist in state of practice.

Responsibilities

• Lead clinical pharmacy services and manage nearly $2B of annual drug expense while ensuring compliance with regulations.
• Direct formulary, policy, prior authorization, and utilization management across commercial, Medicare and Marketplace lines.
• Oversee P&T Committee, MPG, and related governance; manage Medicare and QHP formularies.
• Collaborate across departments and with PBM to optimize access, quality and affordability.
• Develop metrics and drive quality improvement in medication technology assessment.

Skills

Clinical pharmacy

Health economics

Provider contracting

Communication

Pharmacy policy

AI tooling

Education

PharmD

Residency or advanced degree preferred

Job description

Cambia Health Solutions in Vancouver, WA is seeking a Director of Clinical Operations and Medical Policy to direct clinical pharmacy activities, formulary management, and policy development across multiple benefit lines. You will lead a team, oversee governance committees, and drive utilization management and medication policy with impact on members nationwide.

The role requires strategic leadership, strong clinical pharmacy background, and expertise in health economics, policy, and regulatory