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Boise, Idaho, United States
Hybrid
Hybrid role (3 days/week in office) at our Salt Lake City, Boise, Fargo, Portland, Vancouver, Renton, Medford, Burlington, Lewiston, Springdale and Little Rock offices. Preference will be given to current employees and candidates who reside within a commutable distance from our Salt Lake City, Boise, Fargo, Lewiston, Springdale and Little Rock offices or who are willing to relocate.
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 Analysts is living our mission to make health care easier and lives better. As a member of the Pharmacy Informatics team, our The Director of Pharmacy Informatics and Technology leads a team that coordinates pharmacy financial performance reporting, strategic analysis, and decision support tools to improve the efficiency of Cambia's administrative and operational activities. The role is accountable for measuring and reporting PBM vendor contract deliverables, rebate oversight, client reporting, and performance guarantees, while also managing the financial payment cycles to the PBM and supporting health plan pharmacy benefit initiatives. The Director aligns pharmacy informatics with internal partners such as strategic finance, health informatics, underwriting/pricing, actuary, and compliance/audit, and uses analytical and statistical methods to guide staff in evaluating programs, delivering actionable insights, and serving as a content expert on healthcare data. The role also oversees technology systems, production support, automation, and agile delivery, leading the business process automation strategy and large initiatives on operational platforms. In doing so, the Director collaborates with Pharmacy Operations, DTS, Procurement, and Finance to ensure key systems run effectively and that supplier and vendor services align with Cambia's tactical and strategic objectives.
– all in service of creating a person-focused health care experience.
Do you have a passion for serving others and learning new things? Do you thrive as part of a collaborative, caring team? Then this role may be the perfect fit.
What You Bring to Cambia:
Qualifications:
The Director of Pharmacy Informatics and Technology would have a Bachelor's degree in Mathematics, Business, Computer Science, Accounting, or other related field plus 15 years of experience in health care contracting, pharmacy finance or data analysis and five years management experience or an equivalent combination of education and experience.
FTEs Supervised
· Mgrs, multifunctional 10+
Skills and Attributes:
· Proven ability to plan, organize and lead the work of others; develop, document, implement and enforce processes and procedures; recognize process deficiencies and recommend and implement improvements.
· Demonstrated advanced skills in data analysis applications (MS Excel, MS Access), data extraction
· applications (such as SQL), and preferably application programming languages (Visual Basic).
· Proven ability to think analytically, apply analytical techniques and to provide in-depth analysis and recommendations to pharmacy leadership team, senior management, consultants, and vendors, verbally and in writing, using critical thinking and sound judgment.
· Demonstrated ability to communicate effectively with internal and external financial and legal
· departments, focusing on contract deliverables, vendor financial performance, cost/benefit analysis, and problem resolution.
· Demonstrated ability to coordinate work on multiple complex projects supporting clinical, operations, finance, and audit across all lines of business simultaneously to ensure requirements are cleaR&Deadlines are met.
· Demonstrated deep functional and technical knowledge of the Facets system and ancillary technologies that support operations including demonstrated experience managing technical services within a cross functional ecosystem.
· Demonstrated business consulting skills, ability to collaborate with business and vendor partners to conceptualize solutions and define scope, deliverables and implementation plans.
· Successful experience managing the delivery of technology services with high volume processing.
· Experience leading change initiatives including planning, quality methodologies and executing organizational, process and technology change on a large scale.
· Capability to manage internal and external suppliers ensuring they deliver value and meet agreed upon commitments using SWOT analysis, Service Level Agreements, Key Performance Indicators and improvements plans.
· Demonstrated ability to lead high performing teams, manage managers, and direct vendors.
· Strength in strategic thinking, identifying key business issues and opportunities, creating business strategies and driving results across internal teams and/or external partners.
· Ability to coordinate initiatives and bring people together across multiple locations, lines of businesses, and functions.
· Ability to communicate effectively verbally and in writing with all levels of the work force.
· Demonstrated people development and coaching, including a track record of building and maintaining a culture that engages direct reports and employees.
· Demonstrated ability to leverage AI tools and resources to drive efficiency and innovation within area of expertise
What You Will Do at Cambia:
· Provides oversight and measurement of partner PBM deliverables, contract guarantees, and milestones. Helps accelerate partner PBM performance improvement.
· Lead cost and utilization analysis and competitive intelligence benchmarking to identify key trend drivers and facilitates disciplined and holistic management of cost of care trend and quality management strategies.
· Accountable for informatics plans, data analysis programs, and serves as a pharmacy liaison for enterprise-wide technology and complex data projects and systems.
· Oversee the collection and reporting of metrics defining benefits realization and return on investment for integrated products and services, including system design, implementation, documentation, testing and validation, processes re-engineering, training and education to enable informed decision making.
· Provides oversight and direction for pharmacy management dashboards and leading indicator reports including pharmacy cost stewardship activities, monthly financial trend and utilization management reports, performance guarantees, PBM pricing performance, and PBM payment terms.
· Oversee creation and application of financial models to analyze and forecast current and future performance leading to increased operational efficiency, risk mitigation and improved financial performance.
· Provide a high level of comprehensive financial guidance on all aspects of business strategy and management. Demonstrate solid working knowledge of advanced financial concepts and principles.
· Build relationships with and influence a range of stake holders, from cross functional peers to the company's senior executives. Helps to define and negotiate strategic partnerships and relationships with outside partners.
· Oversee the rebate program to ensure accurate data transmission to the pharmaceutical manufacturers; serve as a finance and operational interface between pharmacy leadership, PBM and Cambia finance team; ensure formularies adhere to rebate contract requirements; review and provide guidance regarding clinical and fiscal strategies and rebate opportunities; support administration of ASO client rebate program.
· Manage internal staff on Pharmacy Informatics, project and technology team; resolve personnel issues, develop staff,
· complete performance reviews and monitor budget.
· Support Cambia health plan initiatives related to pharmacy benefit offerings including market pricing
· and ASO billing activities.
· Oversees all activities related to the various electronic systems used to support data acquisition and transactional processing prior to and subsequent to operational processing.
· Supports the business by assessing cost and feasibility of system requests and ensuring plans support both strategic and near-term needs.
· Establishes appropriate working relationships with existing and new strategic vendors, participate in contract negotiations and derive the maximum value from negotiated contracts for technology services and products.
· Ensures, through regular measurement and partnership with DTS and vendors, that the technology service provided throughout Pharmacy Operations meets the business need.
· Evaluates and recommends appropriate computer technology to contribute to the accomplishment of corporate goals.
Work Environment
· No unusual working conditions
· Travel may be required, either locally or out of state
· May be required to work outside normal working hours
Pay ranges vary based on the candidate's work location. The expected hiring range depends on skills, experience, education, and training; relevant licensure / certifications; and performance history.
National pay structure — applies to the Boise and Lewiston, ID; Salt Lake City, UT, Oregon and Washington. The expected salary range is $164,900.00 - $223,100.00. The full salary range is $155,000.00 - $253,000.00 and the bonus target is 25%
.
Regional pay structure — applies to North Dakota and Arkansas, as well as Idaho and Utah locations outside the metro areas listed above: The expected salary range is $148,410.00 - $200,790.00. The full salary range is $139,000.00 - $227,000.00 and the bonus target is 25%.
About Cambia
Working at Cambia means being part of a purpose-driven, award-winning culture built on trust and innovation anchored in our 100+ year history. Our caring and supportive colleagues are some of the best and brightest in the industry, innovating together toward sustainable, person-focused health care. Whether we're helping members, lending a hand to a colleague or volunteering in our communities, our compassion, empathy and team spirit always shine through.
Why Join the Cambia Team?
At Cambia, you can:
We believe a career at Cambia is more than just a paycheck – and your compensation should be too. Our compensation package includes competitive base pay as well as a market-leading 401(k) with a significant company match, bonus opportunities and more.
In exchange for helping members live healthy lives, we offer benefits that empower you to do the same. Just a few highlights include:
Learn more about our benefits.
We are happy to offer work from home options for most of our roles. To take advantage of this flexible option, we require employees to have a wired internet connection that is not satellite or cellular and internet service with a minimum upload speed of 5Mb and a minimum download speed of 10 Mb.
As part of our security requirements, new hires will need access to a personal mobile device to set up Multi-Factor Authentication (MFA) upon joining the company. MFA is an important layer of protection for accessing Cambia systems and is required for all employees.
We are an Equal Opportunity employer dedicated to a drug and tobacco-free workplace. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, age, sex, sexual orientation, gender identity, disability, protected veteran status or any other status protected by law. A background check is required.
If you need accommodation for any part of the application process because of a medical condition or disability, please email CambiaCareers@cambiahealth.com. Information about how Cambia Health Solutions collects, uses, and discloses information is available in our Privacy Policy.
