Medicare Pharmacy Programs Manager, II, or Sr DOE

Cambia Health Solutions • Boise, ID

6d • Hybrid

About The Position

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.

Requirements

• 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
• 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.

Nice To Haves

• Experience in clinical area preferred.
• Experience with AI tools and technologies to enhance productivity and decision-making in professional settings highly desire.

Responsibilities

• 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.

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.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level