Pharmacy Project Manager

Lets do great things together!

About Moda
Founded in Oregon in 1955 Moda is proud to be a company of real people committed to quality. Today like then were focused on building a better future for healthcare. That starts by offering outstanding coverage to our members compassionate support to our community and comprehensive benefits to our employees. It keeps going by connecting with neighbors to create healthy spaces and places together. Moda values diversity and inclusion in our workplace. We aim to demonstrate our commitment to diversity through all our business practices and invite applications from candidates that share our commitment to this diversity. Our diverse experiences and perspectives help us become a stronger organization. Lets be better together.

Position Summary
This is a FT hybrid position based in Portland. The Pharmacy Project Manager serves as a central point of coordination for cross-functional pharmacy operations initiatives ensuring projects remain organized timelines are met stakeholders stay informed and operational priorities continue moving forward efficiently. This role is responsible for leading and coordinating projects that support pharmacy operations including new client implementations operational program launches process improvements regulatory initiatives and strategic departmental priorities.

Working closely with pharmacy leadership operations and clinical teams account management information technology vendor partners compliance and other internal and external stakeholders the Pharmacy Project Manager facilitates collaboration across departments to ensure projects are effectively planned executed and implemented.

This position plays a key role in identifying operational gaps developing structured project plans and workflows improving accountability managing project milestones risks and dependencies and driving successful implementation from planning through post-implementation support. This role helps ensure operational readiness consistent execution and continuous improvement across pharmacy operations.

Pay Range
$59922.05 $74902.56annually (depending on experience).
*Actual pay is based on qualifications. Applicants who do not exceed the minimum qualifications will only be eligible for the low end of the pay range.

Please fill out an application on our company page linked below to be considered for this position.

Dental Vision Pharmacy Life & Disability

Required Skills Experience & Education:

1. Bachelors degree or equivalent combination of education and relevant experience in healthcare administration business administration pharmacy project management or a related field.
   
2. Five or more years of professional experience in pharmacy operations pharmacy benefit management health plan administration or a closely related healthcare environment.
   
3. Demonstrated knowledge of pharmacy benefit administration pharmacy operations claims adjudication and regulatory requirements across Commercial Exchange Medicare and Medicaid lines of business.
   
4. Demonstrated experience leading or coordinating complex cross-functional projects operational implementations system enhancements or process improvement initiatives.
   
5. Experience supporting new client implementations operational readiness activities or enterprise project deployments within a healthcare environment preferred.
   
6. Working knowledge of pharmacy operations claims administration benefit configuration reimbursement methodologies and pharmacy operational workflows.
   
7. Demonstrated ability to manage multiple concurrent projects prioritize competing demands and consistently deliver results within established timelines.
   
8. Demonstrated ability to work independently while building collaborative relationships across departments business partners vendors and external stakeholders.
   
9. Strong written verbal presentation and interpersonal communication skills with the ability to communicate effectively with technical and non-technical audiences.
   
10. Demonstrated analytical and problem-solving skills with the ability to identify operational risks evaluate alternatives and recommend practical solutions.
    
11. Proficiency with Microsoft Office applications including Excel Word PowerPoint and Project or comparable project management software. Experience with pharmacy or healthcare operational systems preferred.
    
12. Experience developing project plans facilitating meetings documenting decisions tracking action items and communicating project status to leadership and stakeholders.
    

Preferred Skills Experience & Education:

1. Pharmacy technician license or certification or prior experience working in a pharmacy or pharmacy operations environment.
2. Knowledge of regulatory and operational requirements across Commercial Exchange Medicare and Medicaid lines of business.
3. Experience supporting health plan pharmacy operations pharmacy benefit management prior authorization operations pharmacy claims administration benefit configuration or formulary management.
4. Formal project management training Project Management Professional (PMP) certification Certified Associate in Project Management (CAPM) certification or equivalent project management experience.
5. Experience leading or coordinating new client implementations vendor implementations system enhancements operational readiness activities or enterprise project deployments.
6. Experience managing vendor relationships and coordinating cross-functional initiatives involving internal business teams technology partners and external vendors.

Primary Functions:

Project Leadership

• Lead cross-functional pharmacy operations projects from initiation through implementation and post-implementation support.
• Develop project plans timelines milestones risk mitigation strategies communication plans and success metrics to support successful execution.
• Coordinate implementation activities across Pharmacy Operations Clinical Pharmacy Account Management Information Technology Compliance Customer Service vendor partners and other business stakeholders.
• Monitor project progress proactively identify risks dependencies and barriers and drive timely resolution.
• Facilitate project governance meetings implementation meetings and stakeholder discussions with clear agendas action items and documented follow-up.

Implementation Governance & Operational Readiness

• Lead project management activities supporting new client implementations pharmacy vendor transitions pharmacy program launches and strategic business initiatives.
• Coordinate implementation readiness across impacted departments ensuring timelines deliverables testing training and operational dependencies are completed prior to go-live.
• Partner with internal teams and external vendors to manage implementation plans issue logs decision tracking and cutover activities.
• Conduct post-implementation reviews capture lessons learned and identify opportunities to improve future implementation processes.

Pharmacy Systems & Vendor Management

• Lead the coordination of pharmacy technology enhancement initiatives including claims adjudication prior authorization formulary management and other pharmacy operational platforms ensuring effective project planning stakeholder alignment and successful implementation.
• Coordinate vendor-led implementations system enhancements upgrades and operational changes impacting pharmacy services.
• Partner with business and technical teams to define business requirements coordinate user acceptance testing validate system functionality and support implementation activities.
• Monitor vendor deliverables project timelines and operational performance to ensure commitments are met.
• Escalate complex operational or system issues as appropriate and coordinate cross-functional resolution efforts.

Key Responsibilities

• Manage multiple concurrent projects with competing priorities while maintaining high quality and timely delivery.
• Develop project scopes work plans timelines resource requirements and success metrics.
• Drive accountability by establishing ownership monitoring deliverables and ensuring commitments are completed on schedule.
• Identify project risks operational impacts and implementation dependencies recommending mitigation strategies when needed.
• Support strategic initiatives that improve pharmacy operations regulatory readiness operational performance and service delivery.
• Promote continuous improvement through project management best practices process standardization and effective stakeholder engagement.

Working Conditions & Contact with Others:

• Remote office environment and/or hybrid with extensive close PC and keyboard work and constant sitting. Work in excess of 40 hours per week including evenings and occasional weekends to meet business needs.
• Internally with Pharmacy Operations Clinical Pharmacy Account Management Information Technology Compliance Customer Service and other business departments and organizational leadership as required to support project execution and operational initiatives. Externally with PBM pharmacy technology and operational vendors and external implementation partners and business stakeholders.
  

Together we can be more. We can be better.

Moda Health seeks to allow equal employment opportunities for all qualified persons without regard to race religion color age sex sexual orientation national origin marital status disability veteran status or any other status protected by law. This is applicable to all terms and conditions of employment including recruiting hiring placement promotion termination layoff recall transfer leaves of absences compensation and training.

For more information regarding accommodations please direct your questions to Kristy Nehler and Danielle Baker via our email.