Medicare Pharmacy Programs Manager, II, or Sr DOE

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

Benefits offered by this job

Medical, dental and vision coverage

Annual employer contributions to health savings account

Generous paid time off

Market-leading retirement plan

Up to 12 weeks of paid parental leave

Wellness programs that reward participation

Commute and parking benefits

Job summary

Cambia Health Solutions seeks a Medicare Pharmacy Program Manager to enhance Medicare services and lead pharmacy governance programs. Ideal candidates will have expertise in program management, healthcare operations, and a strong analytical background.

This hybrid role supports various locations including Portland and promises competitive pay ranging from $92,700 to $184,000 based on experience. Join Cambia to contribute to meaningful healthcare innovations in a supportive work culture.

Qualifications

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

Responsibilities

• Plan and develop scope, deliverables, and budget for new initiatives.
• Manage stakeholder relationships and ensure desired outcomes.
• Identify risks and opportunities across programs.

Skills

Analytical thinking

Project management

Cross-functional coordination

Stakeholder engagement

Data analysis

Consensus building

Health plan familiarity

AI tools experience

Education

Bachelor's Degree in Business or Health Care Administration

Master's Degree (preferred)

Job description

Medicare Pharmacy Program Manager, II, or Sr. DOE

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.

Who We Are Looking For

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.

Ready to shape the future of Medicare pharmacy programs that impact millions of lives? What if your expertise in pharmacy program management could drive meaningful change in how people experience health care? Then this role may be the perfect fit.

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 desire.

What You Will Do at Cambia

• 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.

Compensation

Pay ranges vary based on the candidate's work location. The expected hiring range depends on skills, experience, education, and training; relevant licensure/certifications; and performance history.

• Program Manager (Oregon, Washington, Utah, and Idaho) – Expected hiring range: $92,700 – $125,400, full salary range: $87,000 – $142,000, bonus target: 15%.
• Program Manager (North Dakota) – Expected hiring range: $90,906.79 – $122,991.55, full salary range: $80,716.23 – $133,182.10.
• Program Manager II (Oregon, Washington, Utah, and Idaho) – Expected hiring range: $111,400 – $150,700, full salary range: $104,000 – $171,000, bonus target: 15%.
• Program Manager II (North Dakota) – Expected hiring range: $114,251.88 – $154,576.08, full salary range: $101,444.41 – $167,383.55.
• Program Manager Sr (Oregon, Washington, Utah, and Idaho) – Expected hiring range: $136,000 – $184,000, full salary range: $128,000 – $208,000, bonus target: 15%.
• Program Manager Sr (North Dakota) – Expected hiring range: $128,145.07 – $173,372.75, full salary range: $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.

We are happy to offer work from home options for most of our roles. To take advantage of this flexible option, we require employees to have a wired internet connection that is not satellite or cellular and internet service with a minimum upload speed of 5Mb and a minimum download speed of 10 Mb.

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.

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