Lead, Pharmacy Quality & Affordability Programs

Cambia Health; Boise (ID); Hybrid; USD 140,000 - 228,000; Full time

Benefits offered by this job

Medical coverage

Dental and vision coverage

401(k) with company match

Job summary

Cambia Health is seeking a Manager Clinical Pharmacy Quality and Affordability Programs to lead a team of clinical pharmacists in designing and optimizing quality, affordability, and medication management across lines of business. The role collaborates across Pharmacy, Quality, Analytics, and external partners to improve outcomes and cost efficiency.

You will oversee Medicare Stars, HEDIS initiatives, and medication use policies, guiding strategic initiatives while ensuring regulatory compliance

Qualifications

• Pharmacy degree required with a state license.
• Minimum 3 years in patient care and management or senior business roles in health care delivery.
• Experience in managed care, medical group, hospital, or related field is preferred.

Responsibilities

• Develops, prioritizes, implements, and optimizes pharmacy quality, affordability, and medication management programs.
• Leads cross-functional initiatives with Pharmacy, Quality, Analytics, Product, Provider Enablement, Care Management, Operations, and external vendors.
• Ensures service levels and contractual compliance; manages reporting and analytics for programs.
• Provides leadership and mentorship to direct reports and staff performance reviews.
• Oversees vendor relationships, governance, and opportunity evaluation to support priorities.
• Identifies regulatory changes and innovation opportunities to improve quality outcomes and costs.

Skills

Clinical pharmacotherapy

Leadership / people management

Healthcare economics

Strategic initiative execution

Vendor management

Stakeholder influence

Data analysis

Staff development

Regulatory and compliance knowledge

AI tools knowledge

Education

Bachelor's degree in Pharmacy or Pharm.D

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

Job description

Cambia Health is seeking a Manager Clinical Pharmacy Quality and Affordability Programs to lead a team of clinical pharmacists in designing and optimizing quality, affordability, and medication management across lines of business. The role collaborates across Pharmacy, Quality, Analytics, and external partners to improve outcomes and cost efficiency.

You will oversee Medicare Stars, HEDIS initiatives, and medication use policies, guiding strategic initiatives while ensuring regulatory compliance