Program Coordinator
Cambia Health Solutions

Boise, Idaho

Posted in Health and Safety


This job has expired.

Job Info


Program Coordinator (Pharmacy)Remote within WA, OR, ID, or UT. Candidates outside of these states will not be considered.

Responsible for partnering with clinical stakeholders to develop, execute, evaluate and maintain clinical programs and strategies to support cost containment and clinical quality improvements related to pharmacy. Performs project management, team leadership, system analysis, research & design for purposes of project completion. Guides and assists in pharmacy clinical program outreach, maintains policy/procedures, monitors and reports out on program outcomes, coordinates with other departments to achieve program goals, and assists in vendor management and oversight. Collaborates with Formulary and Prior Authorization teams, Quality and Medicare stars teams, Provider Partnership and Innovation team, and Case Management, among others.


Responsibilities:

  • Helps provide support and intervention on a variety of clinical programs.
  • Analyze metrics to ensure programs are on target.
  • Evaluate, document and manage clinical product offerings on a regular basis to maintain a competitive product portfolio with strong ROI.
  • Provide consultative expertise for strategic provider partners, plan leadership, purchasers, Quality Incentive Plan participants, contracted pharmacy partners and other Health Plan stakeholders as needed.
  • Performs team leadership as part of project management responsibilities. Makes task assignments to project team members and monitors compliance with all project due dates and represents pharmacy services to facilitate communication about current clinical programs.
  • Interacts, coordinates and communicates with all levels of management, internal and external customers such as clients, pharmacy providers, business partners and outside consultants in order to ensure effective use of systems and processes, provide project updates, and ensure coordination of activities.
  • Partner with clinical stakeholders and vendors to accomplish program goals.
  • Represents Pharmacy Services in internal meetings to facilitate communication about current clinical programs.
  • Provide ownership of existing clinical programs, including but not limited to: acting subject matter expert for each assigned program, maintenance of program policies procedures, monitoring program processes and outcomes, program execution, and making data-driven decisions to grow and adapt programs to business needs.
Minimum Requirements
  • Knowledge of claims processing systems. Facets knowledge preferred.
  • Ability to coordinate activities with all levels of staff and external business partners through clear and concise verbal and written communication skills.
  • Demonstrated analytical ability to identify problems, develop solutions and implement a chosen course of action.
  • Ability to organize, plan, prioritize and manage multiple projects within time constraints.
  • Ability to work well under pressure.
  • Demonstrated ability to use MS Office products and other corporate software as required.
  • Knowledge and understanding of pharmacy benefit management industry, benefit design, pharmacy products and services. ​
Normally to be proficient in the competencies listed above

Pharmacy Program Coordinator would have a bachelor's degree and 3-5 years of experience in the health care industry with a focus on pharmacy and prescription drug benefit administration, or equivalent combination of education and experience is a plus. Project management experience and clinical degree or certification preferred.

Regence employees are part of the larger Cambia family of companies, which seeks to drive innovative health solutions. We offer a competitive salary and a generous benefits package. Regence is 2.2 million members, here for our families, co-workers and neighbors, helping each other be and stay healthy and provide support in time of need. We've been here for members for 100 years. Regence is a nonprofit health care company offering individual and group medical, dental, vision and life insurance, Medicare and other government programs as well as pharmacy benefit management. We are the largest health insurer in the Northwest/Intermountain Region, serving members as Regence BlueShield of Idaho, Regence BlueCross BlueShield of Oregon, Regence BlueCross BlueShield of Utah and Regence BlueShield (in Washington). Each plan is an independent licensee of the Blue Cross and Blue Shield Association.

If you're seeking a career that affects change in the health care system, consider joining our team at Cambia Health Solutions. We advocate for transforming the health care system by making health care more affordable and accessible, increasing consumers' engagement in their health care decisions, and offering a diverse range of products and services that promote the health and well-being of our members. Cambia's portfolio of companies spans health care information technology and software development; retail health care; health insurance plans that carry the Blue Cross and Blue Shield brands; pharmacy benefit management; life, disability, dental, vision and other lines of protection; alternative solutions to health care access and free-standing health and wellness solutions.

We are an Equal Opportunity and Affirmative Action employer dedicated to workforce diversity and 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 drug screen and background check are 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.


This job has expired.

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