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Manager, Pharmacy Experience and Access at SCAN Health Plan - ApplyBlast

Manager, Pharmacy Experience and Access

SCAN Health Plan

3 months ago

3.5 on Glassdoor

Remote

Full Time

Senior

0 applicants

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About this role

This role leads and oversees the Part D program for a senior-focused Medicare Advantage Plan, ensuring CMS compliance and operational excellence. The Manager directs team strategies, manages pharmacy benefit manager (PBM) performance, and supervises clinical operations including formulary and utilization management. Key duties include leading audits, optimizing member experience, and serving as a subject matter expert for coverage determinations.

Responsibilities

Design and implement the Medicare Part D program operations
Lead CMS audits and data validation compliance efforts
Oversee PBM performance, formulary operations, and utilization management
Manage and develop a team of pharmacists and support staff
Serve as subject matter expert for coverage determinations

Skills

Qualifications

Pharm D (Doctor of Pharmacy)Active Pharmacist LicensePGY1 ResidencyPGY2 Residency5+ Years Managed Care Experience

About SCAN Health Plan

scanhealthplan.com

SCAN Health Plan is a nonprofit Medicare Advantage health plan operating as an HMO under Medicare. It provides comprehensive coverage with additional benefits such as dental, vision, prescription drugs, OTC allowances, and transportation, serving beneficiaries in California, Arizona, Nevada, New Mexico, Texas, and Washington.