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

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
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
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.

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.

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills & Tools

project managementvendor managementdata analysisprogram metrics developmentperformance managementrisk managementcost managementmonitoring and control procedurescontinuous improvementpharmacy benefits knowledge

Soft Skills

stakeholder managementpresentation skillsproblem-solvingcollaborative relationship buildingmentoringcommunicationaccountabilityleadershipanalytical capabilitiesproactive approach

Certifications

Project Management Professional (PMP)