Vice President Pharmacy Operations & Compliance
Cambia Health Solutions

Portland, Oregon

Posted in Health and Safety


This job has expired.

Job Info


Vice President Pharmacy Operations & Compliance

Oregon, Washington, Utah, Idaho or Remote (in any state except Colorado)

The Vice President of Pharmacy Operations and Compliance provides leadership for pharmacy operational performance across all markets and health plan lines of business, including management and oversight of the contracted Pharmacy Benefit Manager. This position is accountable for planning and implementation of annual benefit changes, new product launches, compliance mandates, enrollment interfaces, claim testing, service operations, digital assets, data management and reporting, Medicare Part D and ACA operations and compliance, and internal and external audit compliance and follow-up. This role partners with leadership across the organization, including pharmacy clinical services, health plan operations, product management, health informatics, legal, finance and sales/account management.

General Functions and Outcomes

  • Provides oversight and measurement of partner PBM deliverables, contract guarantees, and operational milestones. Helps accelerate partner PBM performance improvement; serves as primary operational liaison between Pharmacy Services and partner PBM.
  • Proactively recommends operational process improvements; leads multiple direct reports to deliver standard and ad hoc projects, service enhancements, and problem resolution. Designs and directs implementation of "next level" operational efficiencies.
  • Responsible for aligning resources to execute on "industry best" standards in all aspects of an integrated, regionalized, pharmacy benefit manager - with strong focus on service delivery, risk management, people development, and financial/budget oversight, etc.
  • Is responsible for all internal and external audit operational findings resolution and follow-up.
  • Participation with Pharmacy Leadership Team in development and implementation of short- and long-term business strategy, product development, planning, policy, marketing, account management, and sales execution.
  • Directs the preparation and assembly of the annual Pharmacy Operations and Compliance budget.
  • Directs the definition of scope, assignment of personnel and establishment of target dates and ensures the successful completion of system project commitments while meeting budget, timeliness and functional requirements.
  • Ensures that all pharmacy application modifications and new application systems are thoroughly tested so that system reliability objectives are achieved and so that the results achieve desired business objectives.
  • Evaluates and recommends appropriate computer technology to contribute to the accomplishment of corporate goals.


Minimum Requirements
  • Demonstrated experience leading the growth of an organization characterized by multiple systems, claims configuration, customer related activities, government programs, and health care reform-oriented programs.
  • Ability to identify, champion and drive process improvement changes across multiple functional areas.
  • Knowledge of the pharmaceutical market and pharmaceutical benefit design, set up, execution, and evolution.
  • Knowledge of the health insurance industry, state and federal regulations, and health plan network management and clinical practices.
  • General business acumen including understanding of market dynamics, financial/budget management, data analysis, underwriting and decision making. Expertise in applying data and best practices inform decision making.
  • Proven ability to develop creative strategies to accomplish goals and objectives, plan and execute complex projects and programs, and drive results across internal teams and/or external partners.
  • Ability to effectively manage a team and achieving results through people.
  • Demonstrated ability to independently make tough strategic decisions and move forward with actions on the strategies.
  • Proactive, results oriented and demonstrated ability to meet deadlines under pressure.
  • Proven leadership skills and abilities as demonstrated by progressively increasing management experience and responsibilities.
  • 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


Normally to be proficient in the competencies listed above

The Vice President Pharmacy Operations and Compliance would have Bachelors in Business, Finance, or Health Care related field with an MBA preferred and 12+ years of management level experience in health plan, pharmaceutical benefit management, pharmaceutical manufacturer or health care industry or equivalent combination of education and experience.

FTEs Supervised
  • 40-50


Work Environment
  • No unusual working conditions.
  • Work primarily performed in office environment
  • Travel required, locally or out of state.


At Cambia, we advocate for transforming the health care system. You aren't satisfied with the status quo and neither are we. We're looking for individuals who are as passionate as we are about transforming the way people experience health care. We offer a competitive salary and a generous benefits package. We are an equal opportunity 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 is required.

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 have a century of experience in developing and providing health solutions to serve our members. We had our beginnings in the logging communities of the Pacific Northwest as innovators in helping workers afford health care. That pioneering spirit has kept us at the forefront as we build new avenues to improve access to and quality of health care for the future.

This position includes 401(k), healthcare, paid time off, paid holidays, and more. For more information, please visit www.cambiahealth.com/careers/total-rewards.

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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