Pharmacy Consumer Experience Manager
Cambia Health Solutions

Job Info

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Pharmacy Consumer Experience Manager - Remote

The Pharmacy Consumer Experience Manager is responsible for the improvement of the end to end member pharmacy experience within pharmacy. This role will be the key liaison between the Grievance team, the pharmacy team, the PBM and the Consumer Obsession team, to drive work, identify, and implement continuous process improvement opportunities to continually enhance the consumer experience and interactions with Pharmacy Services and associated vendors. This role requires a passion for delivering results, a commitment to action-orientated analysis and a keen focus on the consumer both external and internal.

Responsibilities:

• Be the primary consumer interface for the pharmacy, PBM and grievance teams, identifying and implementing continuous process improvements that will directly improve the member experience.
• Incubate new ideas and strategies and validate ideas by leading pilots and analyzing the results.
• Responsible for member-centric communications. Facilitate reviews, edits and finalization of any pharmacy communication to members with internal partners and print vendors.
• Leads PBM call center quality oversight work, including monitoring, training, and pilot programs.
• Responsible for responding to all pharmacy OIC complaints and looking for process improvements within those complaints.
• Responsible for managing pharmacy operations C-Express tickets.
• Leads process improvement efforts for all drug prior authorization and appeals processing.
• Develop and maintain strong relationships with business partners and vendors to ensure a clear understanding of the members' needs and efficient delivery of services and solutions.
• Effectively work in a cross-functional team environment throughout Pharmacy by providing feedback on services and communicating any member issues or concerns.
• Actively seek and surface ways to improve the consumer communications. Help serve as a gatekeeper for high standards of consumer communication.
• Proactively keeps leadership abreast of initiative status and potential roadblocks.
• Partner with the Consumer obsession team to share learnings, and best practices on consumer centricity.
• Participate in outreach by teaching, telling stories, and creating experiences that bring the voice of the consumer to life.

Minimum Requirements:

• Ability to distill complicated, technical messages into consumer-friendly language that the average person can understand.
• Excellent communication skills including writing, editing, presenting, listening and facilitating.
• Strong organizational and time management skills. Operates with a high level of autonomy; able to accomplish assigned tasks proficiently and on time.
• Demonstrated ability in identifying problems, mediating issues, developing solutions and solving unknowns and implementing a course of action.
• Strong understanding health/pharmacy literacy and what it means to be consumer-focused.
• Passionate about enhancing the effectiveness of member communication and experience.
• Demonstrated leadership and interpersonal skills and ability to effectively manage projects and vendor relationships. Ability to build strong relationships with key stakeholders, leadership and a variety of groups and individuals at all levels of the organization. Proactively identify needs and strategize with partners to solve business problems and inefficiencies for the consumer.
• Demonstrated understanding of practices and requirements related to pharmacy products & services, CMS, state and federal laws and rules regarding the practice of pharmacy and regulations of health care industry practices, and compliance related activities.
• Demonstrated experience in project management and continuous process improvement including the ability to lead complex implementations with cross-functional teams to achieve desired business results.
• Ability to negotiate and resolve project and team issues with diplomacy and persuasiveness.
• Demonstrated success at driving innovation in a dynamic environment using analytic and quantitative capabilities.

Normally to be proficient in the competencies listed above

Pharmacy Consumer Experience Manager would have a bachelor's degree and 8+ years of experience in health plan/PBM experience and 3 years of consumer-focused engagement or equivalent combination of education and experience.

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.

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