Manager Pharmacy Operations, MI

McLaren Health Care Corp

  • Flint, MI
  • 5 days ago
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    Skills

    • Certified Pharmacy Technician (CPhT)unmatched
    • Compensation and Benefitsunmatched
    • Contract Requirementsunmatched
    • Cross-Functionalunmatched
    • Database Report Toolsunmatched
    • Drug Developmentunmatched
    • Financial Complianceunmatched
    • Formularyunmatched
    • Health Maintenance Organization (HMO)unmatched
    • Health Planunmatched
    • Healthcareunmatched
    • Healthcare Administrationunmatched
    • Healthcare Qualityunmatched
    • Leadershipunmatched
    • Managed Careunmatched
    • Medicaidunmatched
    • Medicareunmatched
    • National Committee for Quality Assurance (NCQA)unmatched
    • On Callunmatched
    • Operations Managementunmatched
    • People Managementunmatched
    • Pharmacyunmatched
    • Regulatory Complianceunmatched
    • Service Deliveryunmatched
    • Team Lead/Managerunmatched
    • Team Playerunmatched
    • Utilization Managementunmatched
    • Utilization Review Accreditation Commission (URAC)unmatched

    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

    Numbers & Facts

    LocationFlint, MI

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