Director Pharmacy Informatics

Cambia Health Solutions•Boise, ID

3d•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 oversees measurement and reporting of PBM vendor contract deliverables, rebates, client reporting, and performance guarantees; manages financial payment cycles to the PBM; and supports health plan pharmacy benefit initiatives. The Director partners with strategic finance, health informatics, underwriting and pricing, actuarial, and compliance and audit teams, applying analytical and statistical methods to evaluate programs and deliver actionable insights. The position also oversees technology systems, production support, automation, and agile delivery, including the business process automation strategy and major initiatives on operational platforms. The Director works with Pharmacy Operations, DTS, Procurement, Finance, and vendors to ensure systems and services meet business needs and align with strategic objectives. The role manages Pharmacy Informatics, project, and technology staff, including managers, and is accountable for staff development, performance reviews, personnel matters, and budget monitoring. It provides financial and strategic guidance, oversees pharmacy reporting and rebate operations, and leads technology-service and vendor relationships. The position is hybrid, with three days per week in the office, and may require local or out-of-state travel and work outside normal hours.

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.
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.
Analytical thinking and ability to apply analytical techniques and present in-depth analysis and recommendations to pharmacy leadership, senior management, consultants, and vendors, verbally and in writing.
Effective communication with internal and external financial and legal departments on 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 clear requirements and meeting deadlines.
Deep functional and technical knowledge of the Facets system and ancillary operational technologies, 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.
Experience managing technology-service delivery in high-volume processing environments.
Experience leading large-scale organizational, process, and technology change initiatives, including planning and quality methodologies.
Ability to manage internal and external suppliers and assess commitments and value using SWOT analysis, service-level agreements, key performance indicators, and improvement plans.
Ability to lead high-performing teams, manage managers, and direct vendors.
Strategic thinking, including identifying business issues and opportunities, developing strategies, and driving results across internal teams and external partners.
Ability to coordinate initiatives across locations, lines of business, and functions.
Effective verbal and written communication with employees at all levels.
People-development and coaching skills, including a record of building and maintaining an engaging culture for direct reports and employees.
Ability to use AI tools and resources to drive efficiency and innovation in the area of expertise.
Ability to travel locally or out of state and work outside normal working hours when required.
For the work-from-home option, a wired, non-satellite and non-cellular internet connection with at least 5 Mbps upload and 10 Mbps download speeds is required.
Access to a personal mobile device to set up required multi-factor authentication upon joining the company.
Successful completion of a background check.

Nice To Haves

Experience with application programming languages such as Visual Basic.

Responsibilities

Oversee and measure PBM partner deliverables, contractual guarantees, and milestones, and support partner performance improvement.
Lead cost and utilization analyses and competitive-intelligence benchmarking to identify trends and inform cost-of-care and quality-management strategies.
Own informatics plans and data-analysis programs, serving as the 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, including cost stewardship, financial trends, utilization management, performance guarantees, PBM pricing, and payment terms.
Oversee financial models used to analyze and forecast business performance, improve efficiency, mitigate risk, and support financial results.
Provide financial guidance on business strategy and management.
Build relationships with stakeholders and help define and negotiate strategic partnerships with external partners.
Oversee rebate operations, including accurate data transmission to manufacturers, coordination among pharmacy leadership, the PBM, and Cambia Finance, formulary compliance with rebate contracts, review of clinical and fiscal strategies and rebate opportunities, and support of ASO client rebate administration.
Manage Pharmacy Informatics, project, and technology staff; address personnel issues; develop staff; conduct performance reviews; and monitor budgets.
Support health plan pharmacy-benefit initiatives, including market pricing and ASO billing.
Oversee electronic systems supporting data acquisition and transactional processing before and after operational processing.
Assess the cost and feasibility of system requests and ensure plans address strategic and near-term business needs.
Establish relationships with strategic vendors, participate in contract negotiations, and seek value from technology-service and product contracts.
Measure and work with DTS and vendors to ensure technology services in Pharmacy Operations meet business needs.
Evaluate and recommend computer technology that supports corporate goals.

Benefits

Medical, dental, and vision coverage for employees and eligible family members, including mental health benefits.
Annual employer contribution to a health savings account.
Paid time off that varies by role and tenure, plus 10 company-paid holidays.
Paid parental time off of up to 12 weeks, subject to eligibility requirements.
401(k) retirement plan with a company match and potential discretionary contribution based on company performance.
Bonus opportunities, with a 25% target stated for the listed pay structures.
Wellness programs with rewards for participation.
Employee Assistance Fund.
Commute and parking benefits.
Employee resource groups.
Cambia-supported community outreach programs.
Flexible work-from-home options for most roles, subject to stated requirements.