Become a part of our caring community and help us put health first
The Clinical Pharmacy Lead monitors drug development pipeline, and medical literature, while providing clinical support for internal stakeholders. Utilizes broad understanding of managed care and PBM knowledge to develop, and/or implement strategies and programs to mitigate cost trend and improve health outcomes. The Clinical Pharmacy Lead works on problems of diverse scope and complexity ranging from moderate to substantial.
The Medicaid Pharmacy Director, internally known as a Clinical Pharmacy Lead, Plans, directs, and monitors all financial, operational, professional, and clinical activities for the purposes of pharmacy program development. Implements policies and procedures that ensure the pharmacy department provides optimal pharmaceutical services that meet all legal, accreditation, and certification requirements. Keeps current with State and Federal regulations regarding the practice of Pharmacy and implements changes as necessary to maintain compliance supporting both the business and public relations strategies. Collaborates on research projects and develops proposals for research projects. Develops corporate communications to be shared with senior leadership. Supports trend management by conducting analysis of drug spend, utilization, and/or approval scenarios. Advises executives to develop functional strategies (often segment specific) on matters of significance. Exercises independent judgment and decision making on complex issues regarding job duties and related tasks, and works under minimal supervision. Uses independent judgment requiring analysis of variable factors and determining the best course of action.
Want more jobs like this?
Get Healthcare jobs that are Remote delivered to your inbox every week.
Use your skills to make an impact
Required Qualifications
- Bachelors of Pharmacy or a Doctor of Pharmacy (PharmD)
- Must have an active KY Pharmacist license with the Board of Pharmacy and prefer residence in Kentucky or close proximity.
- Must represent Humana at all meetings of the State's Drug Utilization Review (DUR) Board
- In-depth knowledge and at least 3-5 years demonstrated experience in managed care/managed pharmacy/competitive environment, and/or completion of managed care residency
- Successful track record in facilitating and consulting across teams and managing projects
- Thrives in a fast paced, multi-project work environment while still ensuring attention to detail
- Excellent communication skills, both oral and written
- Proficiency in Microsoft Word, Excel, & PowerPoint
- Expertise in working collaboratively and communicating with staff in different positions and all levels of management positions
Preferred Qualifications
- Pharmacy Licensure in Illinois and/or ability to obtain
- Master's Degree in Business Administration or a related field
- Experience with Microsoft Access & Microsoft Project
- Experience with pharmacy benefits and health benefits
Work-At-Home Requirements
- Must have the ability to provide a high speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense.
- A minimum standard speed for optimal performance of 25x10 (25mpbs download x 10mpbs upload) is required.
- Satellite and Wireless Internet service is NOT allowed for this role.
- A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information
Additional Information:
"This is a hybrid position"
Prefer candidate reside in Kentucky or has the ability to meet locally within 24 hours.
Additional Information
Interview Format:
As part of our hiring process for this opportunity, we will be using an interviewing technology called Modern Hire to enhance our hiring and decision-making ability. Modern Hire allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule
Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from Humana@myworkday.com with instructions on how to add the information into your official application on Humana's secure website.
Work-At-Home Requirements
To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:
At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested
Satellite, cellular and microwave connection can be used only if approved by leadership
Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.
Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information
#IND123
Scheduled Weekly Hours
40
Pay Range
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$123,800 - $170,400 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
Description of Benefits
Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
About us
Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
Equal Opportunity Employer
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or because he or she is a protected veteran. It is also the policy of Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.