Description

The Pharmacy and Therapeutics Quality and Process Professional 2 is an integral part Humana's Clinical Formulary Strategy team. Humana is seeking a positive and proactive individual to contribute to this high performing team which drives clinical, compliance, and operational execution of Humana's formulary strategies.

Responsibilities

• Assists with Humana's Pharmacy and Therapeutics processes including tracking of metrics to ensure regulatory compliance and identifying opportunities for process improvement to drive quality and efficiencies.
• Assists with all compliance related tasks including, but not limited to reporting of quality events, evaluation of business related impacts, and execution of remediation plans.
• Collaborates across various functional areas to identify and implement compliance opportunities and improvements.
• Proactively assesses suite of pharmacy communication products to ensure all are a best-in-class.
• Utilizes process-based methodologies to develop new end to end processes, optimize existing ones, and identify ways to enhance efficiency.
• Responsible for appropriate identification of root causes through effective use of data analysis tools and techniques.
• Creates and communicates business reports, metrics and assists in resource planning models.

• Bachelor's Degree or comparable experience
• Six Sigma Green belt certified or pursuing certification
• Strong project management and organizational skills
• Ability to communicate effectively and create presentations for leadership
• Ability to assimilate, analyze, draw conclusions, and make recommendations from complex data
• Flexible, dynamic personality who works well in a team environment and is also an individual contributor
• Able to give direction and make sound business decisions
• Ability to work in either a team or an individual capacity to achieve goals and meet deadlines
• Working knowledge of all Microsoft Office applications, including Word, PowerPoint, and Excel

• MBA or pursuing degree
• Three years' experience in pharmacy benefits management and Medicare Part D
• Experience developing system enhancements to drive efficiencies
• Previous experience leading others
• Data analysis and experience working with Access, SQL and Excel