Senior Manager - Pharmacy Quality & Medicare Stars

Job Description

Job Description

Company Description

At Henry Ford Health, we're committed to advancing health and improving lives for the millions of people we serve across Michigan and around the world. As one of the nation's leading academic health systems, we provide a comprehensive continuum of care that includes primary and preventive services, specialty and complex care, virtual care, pharmacy, home health, eye care, health insurance, and more. With 12 hospitals and hundreds of ambulatory care locations, including former Ascension Southeast Michigan and Flint Region facilities, our growing network expands access to exceptional care in the communities we serve.

Headquartered in Detroit, Henry Ford Health is helping shape the future of healthcare through the transformative Future of Health: Detroit initiative, a $3 billion investment that is redefining our academic healthcare campus and advancing innovation, research, education, and community impact.

Our work is grounded in purpose, collaboration, and belonging. We empower team members to grow their careers, contribute innovative ideas, and make a meaningful difference every day. Whether you're caring for patients, supporting operations, conducting research, or driving new solutions, you'll be part of a team united by a shared mission: delivering exceptional care, advancing health outcomes, and building healthier communities for all. Job Description

Reporting to the Vice President, Outpatient Pharmacy Services, the Senior Manager—Pharmacy Quality and Medicare Stars is responsible for:

 

• Developing and executing comprehensive strategy for the health plan's pharmacy-related quality measures and programs, including CMS Stars and HEDIS initiatives, ensuring alignment with organizational goals and regulatory requirements.
• Overseeing overall performance management and continuous improvement of pharmacy quality metrics, identifying opportunities for optimization and implementing evidence-based solutions to enhance member outcomes.
• Leading the development, implementation, and monitoring of Part D Stars programs and Medicare Advantage pharmacy initiatives, ensuring compliance with CMS requirements and maximizing performance scores.
• Managing Medication Therapy Management (MTM) programs and related pharmacy quality initiatives, including program design, member engagement strategies, and performance tracking.
• Engaging and collaborating with key stakeholders across the enterprise, including clinical teams, operations, finance, and external partners, to drive alignment and support successful program execution.
• Analyzing pharmacy quality data and performance metrics to identify trends, gaps, and improvement opportunities, presenting findings and recommendations to senior leadership.
• Managing relationships with pharmacy vendors and external partners, ensuring service delivery meets organizational standards and contractual obligations.
• Providing strategic guidance on regulatory changes, industry best practices, and emerging pharmacy quality trends to inform organizational decision-making.
• Overseeing budget management for pharmacy quality and Stars programs, ensuring efficient resource allocation and return on investment.
• Leading cross-functional teams and mentoring pharmacy staff on quality initiatives, program requirements, and performance expectations.

 

Qualifications

EDUCATION/EXPERIENCE REQUIRED:

• Doctor of Pharmacy (PharmD) degree required.
• Residency training preferred.
• Minimum of seven (7) years of professional experience with progressively more responsibility in an integrated health system and/or health plan and experience meeting the unique needs of various health plan populations including Medicare. Demonstrated experience leading Part D Stars, MTM Program, and pharmacy quality initiatives required. Vendor management experience preferred.

Exemplary oral and written communication skills as evidence by prior examples of effective implementation of strategies with a variety of system personnel and patients.

CERTIFICATIONS/LICENSURES REQUIRED: Licensed to practice pharmacy in the State of Michigan.