Manager Clinical Pharmacy Quality and Affordability Programs (Healthcare)

Location: Hybrid, three days per week in the office at offices in Burlington, Renton, Spokane, Vancouver, Portland, Medford, Salt Lake City, Boise, Lewiston, or Fargo. Candidates must live within commuting distance or be willing to relocate.

Expected hiring range: $148,800–$201,300 in Oregon, Washington, Utah, and Idaho; $146,149.85–$197,732.15 in North Dakota. Full salary ranges are $140,000–$228,000 and $129,767–$214,115 respectively, with a 25% bonus target for Oregon, Washington, Utah, and Idaho.

Company

Purpose-driven health care organization focused on creating a person-focused and economically sustainable health care system.

What you will do

• Lead the strategy, development, implementation, and optimization of pharmacy quality, affordability, and medication management programs across pharmacy, medical, and specialty benefits.
• Drive Medicare Stars, HEDIS, medication utilization, member outcomes, affordability, and operational effectiveness initiatives.
• Build partnerships across Pharmacy, Quality, Analytics, Product, Provider Enablement, Care Management, Operations, Network Management, and external vendors.
• Oversee service levels, contractual obligations, quality assurance, policies, procedures, workflows, and compliance with state, federal, and CMS requirements.
• Manage vendor relationships, program reporting, financial targets, department budgets, workforce allocation, and project plans.
• Lead, mentor, hire, coach, and retain up to 10 direct reports, including clinical pharmacists and non-clinical staff.

Requirements

• Bachelor’s degree in Pharmacy or Pharm.D.; advanced education or residency in a related health care, economics, public health, pharmacy administration, or finance field is preferred.
• At least three years of patient-care experience plus management or professional business experience in managed health care, a medical group, hospital, or related health care delivery organization.
• Licensed pharmacist in the state of practice.
• Strong clinical pharmacy knowledge, health care economics and financing expertise, benefit design knowledge, and understanding of PBM industry dynamics.
• Experience with strategic initiatives, data analysis of medication claims, cross-functional leadership, project coordination, and external vendor or partner management.
• Knowledge of Medicare/CMS regulations, pharmaceutical products, ICD-10, CPT, HCPCS, NDC, HIPAA, PPACA, and state and federal pharmacy and health care laws.

Nice to have

• Residency certificate or advanced degree in a relevant field.
• Experience with AI tools and technologies for productivity and professional decision-making.

Culture & Benefits

• Purpose-driven culture centered on trust, innovation, compassion, health equity, and sustainable person-focused care.
• Medical, dental, vision, and mental health coverage, plus an annual employer health savings account contribution.
• Paid time off, 10 company-paid holidays, up to 12 weeks of paid parental leave, and wellness programs.
• 401(k) retirement plan with a significant company match and potential discretionary contribution.
• Bonus opportunities, employee assistance support, commute and parking benefits, and employee resource groups.
• Work-from-home flexibility is available for most roles, subject to a wired internet connection and minimum connection speeds.