Manager, Pharmacy Operations

About the role

Founded in 1977 as the Senior Care Action Network, SCAN began with a simple but radical idea: that older adults deserve to stay healthy and independent. That belief was championed by a group of community activists we still honor today as the “12 Angry Seniors.” Their mission continues to guide everything we do. Today, SCAN is a nonprofit health organization serving more than 500,000 people across Arizona, California, Nevada, New Mexico, Texas, and Washington, with over $8 billion in annual revenue. With nearly five decades of experience, we have built a distinctive, values-driven platform dedicated to improving care for older adults. Our work spans Medicare Advantage, fully integrated care models, primary care, care for the most medically and socially complex populations, and next-generation care delivery models. Across all of this, we are united by a shared commitment: combining compassion with discipline, innovation with stewardship, and growth with integrity.

Responsibilities

• Ensure regulatory compliance with respect to prescription benefits set up and year-round CMS Program Audit, 1/3 Financial audit, National MEDIC, and other audits readiness;
• Provide leadership and support during all CMS Regulatory Audits related to pharmacy operations;
• e.g., ensure accuracy of written responses and/or documentation for the pharmacy audits;
• Ensure audit documentation is prepared according to audit instructions and provided within the specified audit timeframe;
• Prepare written responses or documentation for pharmacy audits;
• Serve as a subject matter expert for Part D Reporting requirements, Pharmacy Access Requirements, Prescription Drug Event data, Financial Information Reporting and Drug Plan Finder files by keeping up to date with Medicare requirements;
• Maintain current knowledge of Medicare Part D regulations by participating in CMS calls and reading released guidance and implementing changes to maintain compliance.

Requirements

• Five (5) years or more of Medicare Part D experience with a health plan or PBM required;
• Three (3) years of leadership experience in a managed care setting with full scope of supervision for non-licensed staff;
• Three (3) years or more of experience in data analysis required;
• Bachelor's Degree or equivalent experience - Business/Healthcare;
• Active Pharmacy Technician License preferred;
• Expert in Medicare Part D. Knowledge of CMS Part D regulations e.g., CMS Call Letters, MAPD application, Claims Processing, Part D Reports.

Qualifications

• Ability to create, develop and implement process improvement and the ability to instill that focus in a team;
• Ability to work cross-functionally and collaboratively across the organization;
• Technologically savvy and able to utilize information systems effectively (MS Office - Word, Excel, PowerPoint, Access, Visio, Outlook; SQL);
• Ability to manage and adapt to a significant change;
• Strong interpersonal skills, including excellent written and verbal communication skills;
• Strong organizational skills; ability to multitask and meet multiple competing deadlines;
• Ability to appropriately maintain confidentiality. Strong analytical and critical thinking skills.

Skills

• Ability to research, analyze, and problem solve;
• Self-starter that can take the lead on a project and manage its progress for completion.

Benefits

Base salary range: $80,300 to $116,197 per year

Internal title: Manager, Pharmacy Operations

Work Mode: Fully Remote

An annual employee bonus program

Robust Wellness Program

Generous paid-time-off (PTO)

11 paid holidays per year, plus 1 floating holiday, plus 1 birthday holiday

Excellent 401(k) Retirement Saving Plan with employer match and contribution

Roads to Success

Tuition reimbursement

An opportunity to become part of a team that makes a difference to our members and our community every day!

Pay

Base salary range: $80,300 to $116,197 per year

Schedule

Full-time