Who we are

Founded in 1999 and headquartered in Central Ohio, we’re a privately-owned, independent healthcare navigation organization. We believe that no one should have to navigate the cost and complexity of healthcare alone, and we’re on a mission to make healthcare simpler and more effective for our millions of members. Our big-hearted, tech-savvy team fights to ensure that our members get the care they need, when they need it, at the most affordable cost – that’s why we call ourselves Healthcare Warriors®.

We’re committed to building diverse and inclusive teams – more than 2,000 of us and counting – so if you’re excited about this position, we encourage you to apply – even if your experience doesn’t match every requirement.

 

Summary

The Manager, Clinical Program - Pharmacy supports the Vice President, Pharmacy Services by providing leadership, strategic direction, and operational oversight for the Pharmacy program. This role is responsible for people leadership, program performance, client engagement, workforce planning, and continuous improvement initiatives while ensuring high-quality pharmacy services and optimal member outcomes.

The Manager provides leadership and guidance to Pharmacy Leads and clinical staff and serves as the primary escalation point for complex clinical, operational, and client-related issues.

Responsibilities

People & Culture

• Support recruiting and retention efforts, including participation in new hire selection.
• Provide direct leadership and management of pharmacists, nurses, and support staff.
• Develop Pharmacy Leads and other leadership-level team members while ensuring consistent application of coaching frameworks across the department.
• Deliver performance feedback and provide performance management and coaching to support employee development and maximize team success.
• Foster a collaborative, community-oriented culture that recognizes and rewards innovation, enhancing both member and employee satisfaction.
• Establish onboarding, training, competency, and quality standards for the Pharmacy program and ensure Pharmacy Leads execute development plans consistently across teams.
• Conduct regular one-on-one meetings and quarterly performance reviews with assigned staff, utilizing data and insights provided by the Clinical Quality team.
• Lead succession planning and Individual Development Plan (IDP) processes to support professional growth and identify high-potential talent.
• Oversee workforce planning, service levels, productivity targets, and resource allocation across the Pharmacy program.
• Facilitate department-wide communications, strategic planning sessions, leadership meetings, and organizational initiatives impacting Pharmacy Services.
• Promote a culture of camaraderie, partnership, and collaboration.
• Ensure accountability and shared responsibility for delivering high-quality member and provider support.

Client Experience

• Build and maintain effective client relationships while ensuring alignment with client expectations.
• Collaborate with external plan partners, including Third-Party Administrators (TPAs), Pharmacy Benefit Managers (PBMs), and vendor partners, to support client plans and address member concerns.
• Identify and resolve issues to maintain exceptional client and member service, escalating trends and risks to leadership as appropriate.
• Partner with organizational leadership to support successful client implementations and keep Client Executives informed of emerging issues and trends.
• Participate as a clinical leader during prospective and current client meetings and site visits.
• Provide clinical consultation and support to Pod Leadership and Client Engagement Group (CEG) teams for escalated client cases.
• Serve as the primary clinical representative during advocacy reviews and clinical audits by:
  • Presenting audit materials and findings.
  • Responding to stakeholder questions.
  • Identifying and summarizing key themes and improvement opportunities.
  • Collaborating with Clinical Quality & Accreditation, Clinical Training, Clinical Program Leadership, Clinical Delivery Leadership, and Pod Leadership teams.

Clinical Leadership & Subject Matter Expertise

• Reinforce expectations related to workflows, processes, protocols, and program design.
• Serve as an accessible resource for staff, answering questions and clarifying expectations.
• Assist with resolution of escalated issues and complex clinical or operational challenges.
• Communicate client expectations, business performance metrics, member satisfaction insights, and team culture initiatives.
• Support specialty clinical teams by:
  • Triaging Patient Service Representative (PSR) inquiries.
  • Providing clinical guidance and consultation.
  • Reviewing and resolving clinical questions or delegating as appropriate.
  • Serving as a clinical resource for leaders and specialty team staff.
• Monitor and adjust daily clinical workloads to ensure operational effectiveness.
• Maintain a comprehensive understanding of clinical workflows, policies, and procedures.
• Support team members in resolving issues, obtaining necessary information, and improving the overall member healthcare experience.

 

Qualifications

Licensure & Credentialing

• Must hold an active, unrestricted, and unencumbered professional license in good standing with the applicable state licensing board in one of the following disciplines:

  • Pharmacist (R.Ph. or PharmD) or Registered Nurse (RN) holders
  • Other independently licensed healthcare professional authorized to conduct clinical assessments

• Where applicable, clinicians must maintain a Multi-State License (MSL) issued through the appropriate licensure compact (for example, the Nurse Licensure Compact for RNs).

• For clinicians residing in states that do not offer an MSL, or disciplines without an established multistate licensure program, individuals must be willing and able to obtain and maintain additional state licenses as required to support members served by the organization.

• All required licenses, including MSLs and additional state licenses, must be obtained within 90 days of hire.

• Ongoing maintenance, timely renewal, and compliance with all licensure requirements and state board regulations are conditions of employment.

 

Education, Skills & Experience

Required

• Doctor of Pharmacy (PharmD).
• Minimum of 5 years of pharmacy experience.
• Minimum of 3 years of pharmacy leadership, management, or supervisory experience.

Preferred

• 3 to 5 years of experience managing a pharmacy team.
• Experience mentoring, coaching, and developing clinical professionals in a healthcare environment.

 

Knowledge & Skills

• Expertise in:

  • Managed care
  • Specialty pharmacy
  • Utilization management
  • Pharmacy Benefit Manager (PBM) operations
  • Performance coaching
  • Analytics and reporting
  • Client relationship management

• Excellent verbal, written, and presentation communication skills.

• Proven ability to drive results in a high-service healthcare, insurance, or managed care environment.

• Strong leadership, organizational, and workforce planning skills.

• Knowledge of interdisciplinary clinical operations and healthcare delivery models.

• Ability to analyze operational performance and implement continuous improvement initiatives.

• Commitment to protecting confidential company and member information and operating in accordance with organizational ethics, compliance standards, and data security policies.

 

Key Competencies

• Strategic Leadership
• People Development & Coaching
• Client Relationship Management
• Pharmacy Operations Management
• Workforce Planning
• Clinical Expertise
• Performance Management
• Process Improvement
• Quality & Compliance
• Communication & Collaboration
• Problem Solving & Decision Making
• Member-Centered Service Excellence

       

What’s in it for you:

• Compensation: Competitive base and incentive compensation
• Coverage: Health, vision and dental featuring our best-in-class healthcare navigation services, along with life insurance, legal and identity protection, adoption assistance, EAP, Teladoc services and more.
• Retirement: 401(k) plan with up to 4% employer match and full vesting on day one.
• Balance: Paid Time Off (PTO), 7 paid holidays, parental leave, volunteer days, paid sabbaticals, and more.
• Development: Tuition reimbursement up to $5,250 annually, certification/continuing education reimbursement, discounted higher education partnerships, paid trainings and leadership development.
• Culture: Recognition as a Best Place to Work for 15+ years, dedication to diversity, philanthropy and sustainability, and people-first values that drive every decision.
• Environment: A modern workplace with a casual dress code, open floor plans, full-service dining, free snacks and drinks, complimentary 24/7 fitness center with group classes, outdoor walking paths, game room, notary and dry-cleaning services and more!

What you should know:

• Internal Associates: Already a Healthcare Warrior? Apply internally through Lever
• Process: Application > Recruiter Video Interview > Online Assessment(s) > Interview(s) > Offer > Background Check.
• Diversity, Equity and Inclusion: Quantum Health welcomes everyone. We value our diverse team and suppliers, we’re committed to empowering our ERGs, and we’re proud to be an equal opportunity employer .
• Tobacco-Free Campus: To further enable the health and wellbeing of our associates and community, Quantum Health maintains a tobacco-free environment. The use of all types of tobacco products is prohibited in all company facilities and on all company grounds.
• Compensation Ranges: Compensation details published by job boards are estimates and not verified by Quantum Health. Details surrounding compensation will be disclosed throughout the interview process. Compensation offered is based on the candidate’s unique combination of experience and qualifications related to the position.
• Sponsorship: Applicants must be legally authorized to work in the United States on a permanent and ongoing future basis without requiring sponsorship.
• Agencies: Quantum Health does not accept unsolicited resumes or outreach from third-parties. Absent a signed MSA and request/approval from Talent Acquisition to submit candidates for a specific requisition, we will not approve payment to any third party.

Reasonable Accommodation: 

Should you require reasonable accommodation(s) to participate in the application/interview/selection process, or in order to complete the essential duties of the position upon acceptance of a job offer, click here to submit a recruitment accommodation request.

Recruiting Scams: 

Unfortunately, scams targeting job seekers are common. To protect our candidates, we want to remind you that authorized representatives of Quantum Health will only contact you from an email address ending in @quantum-health.com. Quantum Health will never ask for personally identifiable information such as Date of Birth (DOB), Social Security Number (SSN), banking/direct/tax details, etc. via email or any other non-secure system, nor will we instruct you to make any purchases related to your employment. If you believe you’ve encountered a recruiting scam, report it to the Federal Trade Commission and your state’s Attorney General.

 

California Employee and Job Applicant Notice of Collection of Personal Information:

If you are a California resident, Quantum Health may collect personal information in connection with your application for employment and, if hired, during the course of your employment. The categories of personal information collected and the purposes for which that information is used are described in our California Employee and Job Applicant Notice of Collection of Personal Information. 

Please review the notice here:

California Employee and Job Applicant Notice

 

Use of Technology Notice:

Quantum Health and its authorized service providers may contact applicants by email, phone, and text message about their application and related employment opportunities. Text messages may cover application status, interview invitations, and reminders, and applicants will have the option to opt out at any time. Message frequency varies. Message and data rates may apply.

Quantum Health uses AI-assisted recruiting technology to support communication, scheduling, and candidate evaluation, including tools that may review application materials and analyze recorded interviews. These tools assist our recruiting team; final employment decisions are made by human reviewers. Applicants who will be interviewed using these tools receive advance notice describing the technology and what it evaluates, are asked for permission before the interview is recorded or analyzed, and may request deletion of their recording.