Pharmacy Quality & Affordability Programs Manager

Cambia Health

Lewiston (ID)

Hybrid

USD 149,000 - 201,000

Full time

11 days ago

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Benefits offered by this job

Health benefits

Work from home options

401(k) plan with company match

Job summary

Cambia Health is seeking a Manager Clinical Pharmacy Quality and Affordability Programs to lead a team of clinical pharmacists and drive strategy across pharmacy quality, affordability, and medication management initiatives. The role supports Medicare Stars, HEDIS, and related programs while aligning with Cambia's overall health care objectives and patient outcomes.

The position reports to Pharmacy Service leadership and involves building partnerships across Pharmacy, Quality, Analytics, and

Qualifications

Bachelor's degree in Pharmacy or Pharm.D.; licensed pharmacist.
Residency or advanced degree in healthcare administration, economics, public health, pharmacy administration, finance, or equivalent field preferred.
Minimum 3 years of experience in patient care setting as well as management or professional business experience in a managed health care system, medical group, hospital, or related business in health care delivery industry or an equivalent combination of education and experience.

Responsibilities

Develops, prioritizes, implements, and optimizes pharmacy quality, affordability, and medication management programs, including Medicare Stars, HEDIS, and other clinical initiatives.
Builds partnerships and leads cross-functional initiatives involving Pharmacy, Quality, Analytics, Product, Provider Enablement, Care Management, Operations, Network Management, and external vendors.
Assures service levels and activities meet client SLAs and regulatory obligations with governance and compliance.
Provides routine reporting and analysis of clinical program activities with QA and documented workflows.
Provides leadership and mentorship to direct reports, including clinical and non-clinical staff.