Pharmacy Operations Manager - Managed Care

McLaren; Flint (MI); On-site; USD 120,000 - 160,000; Full time

Job summary

McLaren Health Plan is seeking a Manager, Pharmacy Operations to lead the organization’s pharmacy program across Medicaid, Medicare Advantage and Commercial lines. This licensed clinician will provide strategic oversight and day-to-day management, collaborating with medical management, quality, compliance, and external PBM partners to drive cost-effective, compliant services.

The role emphasizes leadership, program development, formulary management, and performance improvement across all LOBs,

Qualifications

• Bachelor's degree or an Associate with 2+ years experience.
• Licensed Michigan Pharmacist (RPh) in good standing.
• 5 years in pharmacy with managed care and supervisory roles.

Responsibilities

• Oversee pharmacy program across Medicaid, Medicare Advantage and Commercial lines.
• Collaborate with medical management, quality, compliance, and PBM partners.
• Ensure high-quality, cost-effective and compliant pharmacy services.

Skills

Leadership experience

Supervisory experience

Pharmacy program management

Formulary management

Health plan knowledge

Collaboration across teams

Education

Bachelor's degree in pharmacy

Associate degree with 2+ years experience

Tools

NCQA familiarity

Population health analytics platforms

Pharmacy claims data tools

CHAMPS system

Job description

McLaren Health Plan is seeking a Manager, Pharmacy Operations to lead the organization’s pharmacy program across Medicaid, Medicare Advantage and Commercial lines. This licensed clinician will provide strategic oversight and day-to-day management, collaborating with medical management, quality, compliance, and external PBM partners to drive cost-effective, compliant services.

The role emphasizes leadership, program development, formulary management, and performance improvement across all LOBs,