Pharmacy Program Manager: PBM & Medicaid/Medicare Ops

Socket.dev; Flint (MI); On-site; USD 105,000 - 145,000; Full time

Job summary

McLaren Health Plan seeks a Pharmacy Program Manager to oversee the PBM vendor relationship, contract compliance, and Rx program implementation across all lines of business. This role will serve as the operational bridge between McLaren Health Plan and its PBM partner to meet contractual obligations and drive quality initiatives.

The candidate will work cross-functionally with clinical, compliance, quality, finance and regulatory teams to optimize pharmacy benefit performance and member outcomes.

Qualifications

• Bachelor's degree in pharmacy, healthcare administration, business, or related field; or an Associate degree with 2 years related experience; or a GED with 4 years related experience.

Responsibilities

• Oversee end-to-end PBM vendor relationship, contract compliance and Rx program implementation.
• Collaborate with clinical, compliance, quality, finance and regulatory teams to drive program outcomes across Medicaid, Medicare and Commercial lines.
• Ensure operational excellence in pharmacy benefit performance and member outcomes.

Skills

PBM management

Vendor management

Project management

Education

Bachelor's degree (pharmacy/healthcare administration/business)

Associate degree + 2 years related experience

High School Diploma + 4 years related experience

Job description

McLaren Health Plan seeks a Pharmacy Program Manager to oversee the PBM vendor relationship, contract compliance, and Rx program implementation across all lines of business. This role will serve as the operational bridge between McLaren Health Plan and its PBM partner to meet contractual obligations and drive quality initiatives.

The candidate will work cross-functionally with clinical, compliance, quality, finance and regulatory teams to optimize pharmacy benefit performance and member outcomes.