Medicare Pharmacy Programs Manager, II, or Sr DOE

Cambia Health Solutions; Medford (OR); Hybrid; USD 92,700 - 125,400; Full time

Benefits offered by this job

Medical, dental, and vision coverage

Generous paid time off

401(k) retirement plan with match

Wellness programs

Commute and parking benefits

Job summary

Cambia Health Solutions is seeking a Medicare Pharmacy Program Manager for a hybrid role based in Medford, Oregon. You will drive pharmacy programs within Medicare, overseeing governance and enhancing program offerings to ensure a person-focused health experience.

The ideal candidate will have at least 5 years of project management experience in healthcare, a Bachelor's degree in a related field, and strong analytical and stakeholder management skills.

Join us at Cambia to contribute to sustainable, innovative health care solutions.

Qualifications

• Minimum 5+ years' experience with project and/or program management in healthcare.
• Experience in clinical area is preferred.
• Equivalent combination of education and experience may be accepted.

Responsibilities

• Work closely with project sponsors and teams to develop program deliverables.
• Manage internal/external stakeholder relationships effectively.
• Identify risks and opportunities across initiatives.

Skills

Analytical thinking

Project management

Financial techniques

Cross-functional communication

Stakeholder relationship management

Data analysis

Consensus building

Health plan terminology

AI tools familiarity

Education

Bachelor's Degree in Business, Health Care Administration, or related field

Master's degree preferred

Job description

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.

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 desired.

What You Will Do

• 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 workstreams 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 cross-functional managers/directors to develop program monitoring and assessment protocols for evaluation and improvement. Recommend program and process changes as appropriate.

Pay Ranges - Program Manager

• Oregon, Washington, Utah, and Idaho: The expected hiring range is $92,700 - $125,400, the full salary range is $87,000 - $142,000 and the bonus target for this position is 15%.
• North Dakota: The expected hiring range is $90,906.79 - $122,991.55 and the full salary range is $80,716.23 - $133,182.10.

Pay Ranges - Program Manager II

• Oregon, Washington, Utah, and Idaho: The expected hiring range is $111,400 - $150,700, the full salary range is $104,000 - $171,000 and the bonus target for this position is 15%.
• North Dakota: The expected hiring range is $114,251.88 - $154,576.08 and the full salary range is $101,444.41 - $167,383.55.

Pay Ranges - Program Manager Sr

• Oregon, Washington, Utah, and Idaho: The expected hiring range is $136,000 - $184,000, the full salary range is $128,000 - $208,000 and the bonus target for this position is 15%.
• North Dakota: The expected hiring range is $128,145.07 - $173,372.75 and the full salary range is $113,780.47 - $187,737.35.

About Cambia

Working at Cambia means being part of a purpose-driven, award-winning culture built on trust and innovation anchored in our 100+ year history. Our caring and supportive colleagues are some of the best and brightest in the industry, innovating together toward sustainable, person-focused health care. Whether we're helping members, lending a hand to a colleague or volunteering in our communities, our compassion, empathy and team spirit always shine through.

Benefits

• Medical, dental and vision coverage for employees and their eligible family members, including mental health benefits.
• Annual employer contribution to a health savings account.
• Generous paid time off varying by role and tenure in addition to 10 company-paid holidays.
• Market-leading retirement plan including a company match on employee 401(k) contributions, with a potential discretionary contribution based on company performance (no vesting period).
• Up to 12 weeks of paid parental time off (eligibility requires 12 months of continuous service with Cambia immediately preceding leave).
• Award-winning wellness programs that reward you for participation.
• Employee Assistance Fund for those in need.
• Commute and parking benefits.

Equal Opportunity Employer

We are an Equal Opportunity employer dedicated to a drug and tobacco-free workplace. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, age, sex, sexual orientation, gender identity, disability, protected veteran status or any other status protected by law. A background check is required. If you need accommodation for any part of the application process because of a medical condition or disability, please email [e-mail]. Information about how Cambia Health Solutions collects, uses, and discloses information is available in our Privacy Policy.