Manager Pharmacy Operations, MI

McLaren; Flint (MI); On-site; USD 110,000 - 160,000; Full time

Job summary

McLaren Health Plan is seeking a Manager of Pharmacy Operations to provide licensed clinical leadership and strategic oversight of the pharmacy program across Medicaid, Medicare Advantage, and Commercial lines. The role involves partnering with medical management, quality, compliance, finance, and PBM partners to drive high-quality, cost-effective services.

The Manager will report to the Director and lead cross-functional teams in a dynamic health plan environment, ensuring program excellence

Qualifications

• Pharmacist licensure in Michigan or eligible (RPh/CPhT).
• 5 years of pharmacy experience with at least 2 in managed care or PBM operations.
• 2 years of supervisory experience in team management and cross-functional collaboration.

Responsibilities

• Oversee the pharmacy program across Medicaid, Medicare Advantage, and Commercial lines.
• Collaborate with medical management, quality, compliance, finance, and external PBM partner.
• Ensure delivery of high-quality, cost-effective, and compliant pharmacy services.
• Report to the Director and provide clinical leadership for program excellence.

Skills

Team leadership

Clinical operations

Cross-functional collaboration

Pharmacy operations

Education

Bachelor’s degree in pharmacy, healthcare administration, business or related field

Associate degree in pharmacy, healthcare administration, business or related field

Job description

McLaren Health Plan (MHP) is a company with a culture of high performance and a mission to help people live healthier and more satisfying lives. We are looking for a Manager, Pharmacy Operations, to join in leading the organization forward.

MHP is a Managed Care Organization dedicated to meeting the health care needs of each member. MHP offers multiple product lines, including individual and family plans, and Medicaid and Medicare plans to Michigan residents for every stage of life. McLaren Health Plan is accredited by the National Committee for Quality Assurance (NCQA).

MHP values the talents and abilities of all our employees and seeks to foster an open, cooperative and dynamic environment in which employees and the health plan can thrive. As an employee of MHP, you will be a part of a dynamic organization that considers all our employees as leaders in driving the organization forward and delivering quality service to all our members.

Learn more about McLaren Health Plan at https://www.mclarenhealthplan.org

Position Summary

The Manager of Pharmacy Operations is a licensed clinical leadership position responsible for the strategic oversight and day-to-day management of McLaren Health Plan’s pharmacy program across all lines of business (LOB), including Medicaid, Medicare Advantage, and Commercial products. This role serves as a clinical subject matter expert and operational leader, ensuring the delivery of high-quality, cost-effective, and compliant pharmacy services. Reporting to the Director, the Manager position will collaborate closely with medical management, quality, compliance, finance, and external Pharmacy Benefit Manager (PBM) partner to drive pharmacy program excellence.

Required

• • Bachelor’s degree in pharmacy, healthcare administration, business, or a related field; or an Associate degree in pharmacy, healthcare administration, business or a related field and two (2) years’ related experience.
• • Must possess a valid, current, unrestricted Michigan license or certification as either a Certified Pharmacy Technician (CPhT) or Registered Pharmacist (RPh)
• • Five (5) years of progressive pharmacy experience, with at least two (2) years in managed care, health plan, or PBM clinical operations setting.
• • Two (2) years’ experience with formulary management, drug utilization review, and clinical program development.
• • Three (3) years of supervisory experience with specific focus in team management and cross-functional collaboration skills.

Preferred

• • Two (2) years’ Experience with NCQA Health Plan Accreditation and/or Utilization Review Accreditation Commission (URAC) standards.
• • PGY-1 or PGY-2 Managed Care Pharmacy Residency experience.
• • Familiarity with Michigan Medicaid MDHHS contract compliance requirements and CHAMPS system.
• • Proficiency with pharmacy claims data, reporting tools, and population health analytics platforms.
• • Familiarity with McLaren Health Plan, McLaren Health Care, or McLaren Integrated HMO Group products.

Additional Information

• Schedule: Full-time
• Requisition ID: 26004101
• Daily Work Times: 8:30AM – 5:00PM
• Hours Per Pay Period: 80
• On Call: No
• Weekends: No