Manager, Pharmacy Operations - Michigan

Karmanos Cancer Institute; Flint, Northern (MI, KY); Hybrid; USD 100,000 - 140,000; Full time

Job summary

McLaren Health Plan in Michigan seeks a Manager of Pharmacy Operations to lead the pharmacy program across Medicaid, Medicare Advantage and Commercial products. This licensed clinical leadership role combines strategic oversight with day-to-day management and cross‑functional collaboration.

The ideal candidate holds a Michigan RPh license, a pharmacy degree, and at least five years of managed care pharmacy experience, including formulary management and supervision.

Qualifications

• Bachelor’s degree in pharmacy, healthcare administration, business, or related field; or an Associate degree with two years’ related experience.
• Must possess a valid, current, unrestricted Michigan Registered Pharmacist (RPh).
• Five years of progressively responsible pharmacy experience with managed care functions; at least two years in a supervisory role.

Responsibilities

• Oversee the pharmacy program across Medicaid, Medicare Advantage and Commercial products.
• Collaborate with medical management, quality, compliance, finance, and PBM partners to drive program excellence.
• Provide leadership in formulary management, drug utilization review, and clinical program development.

Skills

Pharmacy leadership

Managed care familiarity

Cross-functional collaboration

Education

Pharmacy degree or equivalent

RPh licensed in Michigan

Tools

Formulary management

Utilization review

Job description

McLaren Health Care, headquartered in Grand Blanc, Michigan, is a $7.3 billion, fully integrated health care delivery system committed to quality, evidence-based patient care and cost efficiency. The McLaren system includes 12 hospitals in Michigan, ambulatory surgery centers, imaging centers, a 640-member employed primary and specialty care physician network, commercial and Medicaid HMOs covering more than 732,838 lives in Michigan and Indiana, home health, infusion and hospice providers, pharmacy services, a clinical laboratory network and a wholly owned medical malpractice insurance company. McLaren operates Michigan’s largest network of cancer centers and providers, anchored by the Karmanos Cancer Institute, a National Cancer Institute-designated comprehensive cancer centers. McLaren has 20,000 full-, part-time and contracted employees and more than 113,000 network providers throughout Michigan, Indiana and Ohio.

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.

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.

Qualifications:

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 Registered Pharmacist (RPh).

Five (5) years of progressively more responsible pharmacy experience, with experience and knowledge of HMO, PPO, TPA, PHO, and Managed care functions with at least two (2) years' experience with formulary management, drug utilization review, and clinical program development, including at least two (2) years in a supervisory role leading or assisting in all phases of effective supervision (i.e. Recruitment, performance management, training).

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
• On Call: No

McLaren Health Care is an Equal Opportunity Employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, sexual orientation, gender identification, age, sex, marital status, national origin, disability, genetic information, height or weight, protected veteran or other classification protected by law.

My Profile

Create and manage profiles for future opportunities.

McLaren Health Care is an Equal Opportunity Employer. Qualified applicants will receive consideration for employmentwithout regard to race, color, religion, sexual orientation, gender identification, age, sex, marital status,national origin, disability, genetic information, height or weight, protected veteran or other classificationprotected by law.