Senior Clinical Pharmacist
About the role
The Senior Clinical Pharmacist plays a crucial role in monitoring clinical criteria to provide clinical support for internal stakeholders. They utilize a comprehensive understanding of managed care and pharmacy benefit managers (PBMs) to implement strategies and programs aimed at mitigating cost trends and enhancing health outcomes.
Responsibilities
- Maintains and operationalizes preferred drug lists related to coverage, utilization management edits, and clinical coverage policies for pharmacy and medical-administered drug products.
- Conducts analysis on drug utilization trends to evaluate and inform processes and build needs.
- Supports trend management by analyzing drug spend, utilization, and approval scenarios.
- Begins to influence department strategy by making decisions on moderately complex to complex issues regarding technical approaches for project components.
- Works collaboratively in a team environment and independently on assignments requiring significant autonomy.
Requirements
- Pharmacy Degree (PharmD or RPh) from an accredited School of Pharmacy.
- A current active Pharmacist license with the Board of Pharmacy in the appropriate state.
- Passion for contributing to an organization focused on improving consumer experiences.
- Flexible, dynamic personality capable of working both independently and as part of a team.
- Experience in health plans, particularly in Medicaid.
- Knowledge of Six Sigma and/or Project Management Professional certification.
- Preferred experience in pharmacy practice residency or similar roles.
- Proficiency in Microsoft applications (Excel, PowerPoint, Word).
Preferred Qualifications
- Health Plan experience.
- Knowledge of Medicaid as it relates to pharmacy.
- Six Sigma and/or Project Management Professional certification.
- Pharmacy practice residency or similar pharmacy practice experience.
- Proficiency in Microsoft applications (Excel, PowerPoint, Word).
Work from Home Requirements
To ensure effective work from home, the self-provided internet service must meet the following criteria: at minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps. Wireless, wired cable, or DSL connections are suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary.
Travel
This is a remote position, but occasional travel to Humana's offices for training or meetings may be required.
Scheduled Weekly Hours
40 hours per week.
Pay Range
$126,300 - $173,700 per year.
Description of Benefits
Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits include medical, dental, and vision benefits, a 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, paid parental and caregiver leave), short-term and long-term disability, life insurance, and many other opportunities.
About Us
About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our 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 and 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 protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disabilities 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.