Director Pharmacy Informatics

Cambia Health Solutions

1d•$139,000 - $253,000•Hybrid

About The Position

The Director of Pharmacy Informatics and Technology leads a team responsible for pharmacy financial performance reporting, strategic analysis, and decision-support tools that improve the efficiency of Cambia’s administrative and operational activities. The role measures and reports pharmacy benefit manager (PBM) contract deliverables, rebate oversight, client reporting, and performance guarantees; manages financial payment cycles to the PBM; and supports health plan pharmacy benefit initiatives. The Director aligns pharmacy informatics with strategic finance, health informatics, underwriting and pricing, actuarial, and compliance and audit partners, using analytical and statistical methods to evaluate programs and provide actionable insights. The position also oversees technology systems, production support, automation, and agile delivery, and leads business process automation strategy and large initiatives on operational platforms in collaboration with Pharmacy Operations, DTS, Procurement, Finance, and suppliers. The role provides financial and operational oversight of PBM relationships, rebate programs, pharmacy reporting, financial models, and system-supported data acquisition and transaction processing. It leads a Pharmacy Informatics project and technology team, including managers, and manages staff development, performance reviews, personnel issues, and budgets. The Director also advises on technology costs and feasibility, strategic vendor relationships, contract negotiations, and technology services that support Pharmacy Operations. This is a hybrid role requiring three days per week in the office, based at one of the listed Cambia offices. Travel may be required locally or out of state, and work outside normal working hours may be required. The work environment has no unusual working conditions.

Requirements

Bachelor’s degree in Mathematics, Business, Computer Science, Accounting, or a related field, plus 15 years of experience in health care contracting, pharmacy finance, or data analysis and five years of management experience, or an equivalent combination of education and experience.
Proven ability to plan, organize, and lead others; develop, document, implement, and enforce processes and procedures; identify process deficiencies; and implement improvements.
Advanced skills in data analysis applications such as MS Excel and MS Access, and data extraction applications such as SQL.
Strong analytical and critical-thinking skills, including the ability to provide in-depth analysis and recommendations to pharmacy leadership, senior management, consultants, and vendors, verbally and in writing.
Ability to communicate effectively with internal and external financial and legal departments regarding contract deliverables, vendor financial performance, cost-benefit analysis, and problem resolution.
Ability to coordinate multiple complex projects across clinical, operations, finance, and audit functions and lines of business, ensuring requirements are clear and deadlines are met.
Deep functional and technical knowledge of the Facets system and ancillary technologies supporting operations, including experience managing technical services in a cross-functional ecosystem.
Business consulting skills and ability to collaborate with business and vendor partners to define solutions, scope, deliverables, and implementation plans.
Successful experience managing delivery of technology services involving high-volume processing.
Experience leading large-scale change initiatives, including planning, applying quality methodologies, and executing organizational, process, and technology change.
Ability to manage internal and external suppliers using SWOT analysis, service-level agreements, key performance indicators, and improvement plans to ensure value and delivery against commitments.
Ability to lead high-performing teams, manage managers, and direct vendors.
Strategic thinking, including identifying business issues and opportunities, creating strategies, and driving results across internal teams and external partners.
Ability to coordinate initiatives and bring people together across locations, lines of business, and functions.
Effective verbal and written communication with all workforce levels.
People development and coaching skills, including a record of building and maintaining an engaging culture for direct reports and employees.
Ability to leverage AI tools and resources to drive efficiency and innovation within the area of expertise.
Ability to travel locally or out of state as required and work outside normal working hours when required.

Nice To Haves

Experience with application programming languages such as Visual Basic.

Responsibilities

Oversee and measure PBM partner deliverables, contract guarantees, and milestones, and help improve PBM partner performance.
Lead cost and utilization analysis and competitive intelligence benchmarking to identify trend drivers and support cost-of-care and quality-management strategies.
Develop and oversee informatics plans and data analysis programs, serving as a pharmacy liaison for enterprise technology and complex data projects and systems.
Oversee measurement and reporting of benefits realization and return on investment for integrated products and services, including system design, implementation, documentation, testing, validation, process reengineering, training, and education.
Direct pharmacy management dashboards and leading-indicator reports covering cost stewardship, financial trends, utilization management, performance guarantees, PBM pricing performance, and PBM payment terms.
Oversee financial models used to analyze and forecast current and future performance, improve operational efficiency, mitigate risk, and support financial performance.
Provide comprehensive financial guidance on business strategy and management.
Build and influence relationships with cross-functional peers, senior executives, and outside partners; help define and negotiate strategic partnerships.
Oversee the rebate program, including accurate manufacturer data transmission, coordination between pharmacy leadership, the PBM, and Cambia Finance, compliance with rebate contract requirements, review of clinical and fiscal strategies, and administration of ASO client rebates.
Manage Pharmacy Informatics, project, and technology staff; resolve personnel issues, develop staff, complete performance reviews, and monitor budgets.
Support health plan pharmacy benefit initiatives, including market pricing and ASO billing.
Oversee electronic systems supporting data acquisition and transaction processing before and after operational processing.
Assess the cost and feasibility of system requests and ensure plans support strategic and near-term business needs.
Establish relationships with strategic vendors, participate in contract negotiations, and maximize value from technology service and product contracts.
Measure and work with DTS and vendors to ensure technology services meet Pharmacy Operations’ business needs.
Evaluate and recommend computer technology that supports corporate goals.

Benefits

Medical, dental, and vision coverage, including mental health benefits.
Annual employer contribution to a health savings account.
Paid time off and 10 company-paid holidays.
401(k) plan with company match and potential discretionary contribution based on company performance.
Up to 12 weeks of paid parental time off, subject to eligibility requirements.
Wellness programs.
Employee Assistance Fund.
Commute and parking benefits.
Bonus opportunities.
Employee resource groups and Cambia-supported community outreach programs.