Manager, Pharmacy Operations

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.

At SCAN, we believe scale should strengthen—not dilute—our mission. We are building the future of care for older adults, grounded in purpose, accountability, and respect for the people and communities we serve.

The Manager of Pharmacy Operations is responsible for providing leadership and direction to the pharmacy operations team while working cross‑functionally with other departments and the Pharmacy Benefit Manager (PBM) on CMS, DHCS, and other states regulatory requirements. The role ensures regulatory compliance related to prescription drug event (PDE) data, Drug Plan Finder processes, financial information reporting, Part D reporting, pharmacy benefit configuration and testing, and plan benefit package reviews during BID submission.

It provides support during CMS Part D and other regulatory audits (e.g., 1/3 financial audit, National MEDIC audits) and ensures Part D deadlines and time frames are met. This position supports pharmacy leadership to drive departmental and organizational goals. This position oversees pharmacy benefit administrators and pharmacy analysts, providing leadership, direction, and fostering continuous team development.

• 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.
• Oversee the accurate implementation and maintenance of pharmacy benefits, pharmacy account structure, pharmacy network, including GEO access requirements; lead the team to review and ensure the accuracy of the Pharmacy Benefits for the annual BID submission to CMS; ensure Annual Enrollment Period (AEP) and 1/1 operational readiness and assist in training of other departments on Pharmacy products.
• Lead automation efforts related to the Prescription Drug Event, Benefits Configuration and Testing Initiatives; analyze and monitor large data sets that are exchanged from SCAN to the PBM using a variety of reporting tools.
• Accountable for ensuring eligibility and coordination of benefit files are sent to the PBM for processing and assess if file enhancements are needed; ensure the PBM is processing Prescription Drug Events, Automated Claims Reprocessing and Financial Information Data according to CMS regulatory standards by conducting daily oversight; ensure PBM oversight of claims adjudication; oversee PBM operations to ensure high service level to SCAN and our…