Moda Health Pharmacy Manager, Business Development & Innovation in Portland, Oregon

Pharmacy Manager, Business Development & Innovation

Job Title

Pharmacy Manager, Business Development & Innovation


Open until filled





Other Location


Let’s do great things, together

Founded in Oregon in 1955, Moda is proud to be a company of real people committed to quality. Today, like then, we’re 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 Health is seeking a Pharmacy Manager, Business Development & Innovation. This position develops clinical program strategies for prospective clients in support of Moda Pharmacy business growth, and leads pharmacy cost savings initiatives to manage drug spend for Moda Health Plan and their clients. This position focuses on business development through demonstrating the value of Moda clinical pharmacy programs, and drives innovative, data-driven solutions to optimize member outcomes and manage drug spend. This position also focuses on alignment of reimbursement across the pharmacy enterprise for drug spend under both the pharmacy and medical benefits..

Primary Functions:1. Develops and tailors clinical value proposition in support of Moda Pharmacy business growth strategies.2. Works collaboratively with Pharmacy Account Sales and Service team members to develop new business leads and support Requests for Proposal (RFP).3. Develops innovative clinical programs to optimize member outcomes and manage client drug spend. This includes evaluating and enhancing programs overtime, as well as performance reporting.4. Provides clinical expertise and guidance to clients and prospective clients.5. Builds relationships with industry partners in the pharmaceutical and biotechnology markets.6. Develops rebate management strategies in collaboration with PBM partners and internal stakeholders. This includes identifying new rebate opportunities, tracking implementation, ensuring timely reporting, and auditing collection of rebate dollars.7. Drives pharmacy Cost Savings Initiatives, including identifying opportunities, quantifying savings potential, developing businesses cases as applicable, implementing strategies, and measuring outcomes.8. Evaluates formulary and utilization management performance across lines of business (Commercial, Exchange, Medicare, Medicaid) to inform new management strategies and product design.9. Provide concise, applicable, comprehensive, and timely responses to requests for drug information from members and clients.10. Performs other duties as assigned.

Are you ready to be a betterist?

If you’re ready to make a difference that matters, we want to hear from you. Because it’s time to discover what’s possible.

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.

Required Skills

  1. Doctor of Pharmacy degree (Pharm.D.) preferred.

  2. 3 - 5 years of management experience.

  3. Managed care experience related to Commercial, Exchange, Medicare, and Medicaid pharmacy programs.

  4. Technical understanding of pharmacy claims processing information and systems.

  5. Strong analytical, verbal, written, and interpersonal communication skills.

  6. Ability to work well under pressure, work with frequent interruptions and shifting priorities.

  7. Ability to communicate and present complicated and technical information in layman terms.

  8. Ability to lead project teams and implement clinical programs.

  9. Ability to maintain confidentiality and project a professional business image.

  10. Ability to work collaboratively with leadership of the Government Compliance team, including the Compliance Officer, Medical Director, and Pharmacy Director.

  11. Proficient with Microsoft Office applications.

  12. Ability to work independently.

  13. Valid Registered Pharmacist license in the State of Oregon, or ability become licensed within three months of employment.