Manager Pharmacy Operations, MI

About the role

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 will collaborate closely with medical management, quality, compliance, finance, and external Pharmacy Benefit Manager (PBM) partner to drive pharmacy program excellence.

Requirements

• 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.
• 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 Qualifications

• 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.

Schedule

• Full-time
• Daily work times: 8:30 AM – 5:00 PM
• Hours per pay period: 80
• On call: No
• Weekends: No