Pharmacy Operations Program Manager or Sr DOE

Cambia Health Solutions • Portland, OR

4d • Hybrid

About The Position

Pharmacy Operations Program Manager or Sr DOE Hybrid within Oregon, Washington, Idaho or Utah 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 Pharmacy Operations Program Managers are living our mission to make health care easier and lives better. As a member of the Pharmacy Services Operations team, our Pharmacy Operations Program Managers oversee complex pharmacy benefit programs, manage vendor relationships, and drive operational excellence – all in service of creating a person-focused health care experience. Do you thrive on managing complex programs from implementation through optimization? Are you energized by collaborating across teams to solve challenges and drive continuous improvement? Then this role may be the perfect fit. What You Bring to Cambia: Qualifications: Bachelor's degree in business, health administration, or related field and 5+ years of progressive experience in operational/business management, project/program management in healthcare, healthcare insurance operations or other large complex industries, and/or vendor management, or equivalent combination of education and experience Project Management Professional (PMP) certification or equivalent work experience preferred Experience managing end-to-end projects/programs including implementation in a healthcare setting and working with third-party service providers Skills and Attributes: Deep knowledge of pharmacy benefits, insurance operations, and healthcare delivery systems Strong analytical capabilities with ability to perform data-driven analysis of business opportunities and surface actionable insights Proven ability to develop and maintain vendor performance management strategies including scorecarding, SLA monitoring, and business reviews Expertise in project planning, scope management, resource allocation, risk mitigation, and cost management Skilled at establishing monitoring and control procedures for program assessment and continuous improvement Excellent stakeholder management with ability to build collaborative relationships across all organizational levels Strong presentation skills with ability to communicate complex information to leadership, project teams, and client groups Proactive problem-solver who independently identifies opportunities, gaps, and process improvements Ability to escalate and resolve issues effectively, ensuring timely problem resolution Experience facilitating and leading cross-functional teams to address complex operational challenges Capable of mentoring colleagues and acting as a subject matter expert Commitment to establishing personal goals aligned with team mission and maintaining accountability Experience with AI tools and technologies to enhance productivity and decision-making in professional settings highly desired What You Will Do at Cambia: Manage new and buy-up pharmacy benefit programs, collaborating with Rx Product, Rx Informatics, Clinical, GTM, and StratFi teams on strategic decisions, implementations, and program enhancements Develop and maintain comprehensive monitoring and assessment protocols in partnership with program leaders and cross-functional directors, recommending improvements as needed Define, collect, and analyze program metrics to ensure performance targets are met and deliver insights to appropriate leadership forums including Echo report-outs Oversee vendor relationships and performance management, including regular scorecarding, SLA monitoring, risk identification, and continuous improvement initiatives Work with Rx Informatics and configuration teams on metrics development, StratFi for pricing and revenue updates, Clinical for vendor-proposed drug list changes, and vendor dashboards Lead problem management resolution efforts, validate issue prioritization, engage appropriate teams, and escalate to management when necessary to ensure timely resolution Prepare and present operational plans, status reports, and program documents to organizational leadership, project teams, and stakeholders Educate and train leadership, colleagues, business associates, and stakeholders on new program elements, processes, and implementations Drive continuous improvement across all vendor oversight processes, evaluating program outcomes and implementing sustainable operational solutions Facilitate multiple interdependent projects, maintaining accountability for scope, schedule, budget, risk management, and successful delivery of quality outcomes #LI-Hybrid

Requirements

• Bachelor's degree in business, health administration, or related field and 5+ years of progressive experience in operational/business management, project/program management in healthcare, healthcare insurance operations or other large complex industries, and/or vendor management, or equivalent combination of education and experience
• Deep knowledge of pharmacy benefits, insurance operations, and healthcare delivery systems
• Strong analytical capabilities with ability to perform data-driven analysis of business opportunities and surface actionable insights
• Proven ability to develop and maintain vendor performance management strategies including scorecarding, SLA monitoring, and business reviews
• Expertise in project planning, scope management, resource allocation, risk mitigation, and cost management
• Skilled at establishing monitoring and control procedures for program assessment and continuous improvement
• Excellent stakeholder management with ability to build collaborative relationships across all organizational levels
• Strong presentation skills with ability to communicate complex information to leadership, project teams, and client groups
• Proactive problem-solver who independently identifies opportunities, gaps, and process improvements
• Ability to escalate and resolve issues effectively, ensuring timely problem resolution
• Experience facilitating and leading cross-functional teams to address complex operational challenges
• Capable of mentoring colleagues and acting as a subject matter expert
• Commitment to establishing personal goals aligned with team mission and maintaining accountability

Nice To Haves

• Project Management Professional (PMP) certification or equivalent work experience preferred
• Experience managing end-to-end projects/programs including implementation in a healthcare setting and working with third-party service providers
• Experience with AI tools and technologies to enhance productivity and decision-making in professional settings highly desired

Responsibilities

• Manage new and buy-up pharmacy benefit programs, collaborating with Rx Product, Rx Informatics, Clinical, GTM, and StratFi teams on strategic decisions, implementations, and program enhancements
• Develop and maintain comprehensive monitoring and assessment protocols in partnership with program leaders and cross-functional directors, recommending improvements as needed
• Define, collect, and analyze program metrics to ensure performance targets are met and deliver insights to appropriate leadership forums including Echo report-outs
• Oversee vendor relationships and performance management, including regular scorecarding, SLA monitoring, risk identification, and continuous improvement initiatives
• Work with Rx Informatics and configuration teams on metrics development, StratFi for pricing and revenue updates, Clinical for vendor-proposed drug list changes, and vendor dashboards
• Lead problem management resolution efforts, validate issue prioritization, engage appropriate teams, and escalate to management when necessary to ensure timely resolution
• Prepare and present operational plans, status reports, and program documents to organizational leadership, project teams, and stakeholders
• Educate and train leadership, colleagues, business associates, and stakeholders on new program elements, processes, and implementations
• Drive continuous improvement across all vendor oversight processes, evaluating program outcomes and implementing sustainable operational solutions
• Facilitate multiple interdependent projects, maintaining accountability for scope, schedule, budget, risk management, and successful delivery of quality outcomes

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
• Number of Employees: 1,001-5,000 employees