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Clinical Pharmacy Lead

Company: Humana
Location: Louisville
Posted on: September 16, 2020

Job Description:

Description

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. Responsibilities

The Clinical Pharmacy Lead, Medicare Formulary Build manages and coordinates the formulary strategy activities associated with the annual Medicare formulary build process. In addition, the Clinical Pharmacy Lead, Medicare Formulary Build 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, Medicare Formulary Build work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.

Facilitate and document strategic discussions regarding Medicare formularies

Present Medicare formulary coverage recommendation to various internal stakeholders and levels of Humana leadership

Participate in Humana’s formulary and Pharmacy and Therapeutics processes

Complete clinical reviews, policy development and recommend drug coverage and potential drug utilization tools to mitigate Humana’s cost and trend while improving our member’s health and costs

Serve as a clinical subject matter expert and provide clinical support across Humana

Conducts analysis on drug utilization trends to evaluate and inform formulary 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.

Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude in determining objectives and approaches to assignments.

Required Qualifications

Degree of Doctor of Pharmacy

C linical experience in managed care

Knowledge of Medicare as it relates to pharmacy

Experience in analysis and problem-solving

Excellent oral and written communication skills

Flexible, dynamic personality who works well in a team environment and is also an individual contributor

Ability to prioritize, organizes, and executes effective time management

Ability to assimilate, analyze, draw conclusions, and make recommendations from complex data

Ability to work in either a team or an individual capacity to achieve goals and meet deadlines

Preferred Qualifications

Board Certified Pharmacotherapy Specialist

Pharmacoeconomics and Health Outcomes training

Pharmacy practice residency or similar pharmacy practice experience

Six Sigma and/or Project Management Professional certification

Additional Information

Scheduled Weekly Hours

40

Posted 4 Days Ago

Full time

R-238102

About Us About Us

Mission: At Humana, our cultural foundation is aligned to helping members achieve their best health by delivering personalized, simplified, whole-person healthcare experiences. Recognizing healthcare needs continue to evolve for each person, for each family and for each community, Humana continuously creates innovative solutions and resources that help people live their healthiest lives on their terms –when and where they need it. Our employees are at the heart of making this happen and that’s why we are dedicated to building an organization of dynamic talent whose experience and passion center on putting the customer first.

Equal Opportunity Employer

It is our policy to recruit, hire, train, and promote people without regard to race, color, religion, sex, national origin, age, sexual orientation, gender identity or expression, disability, or veteran status, except where age, sex, or physical status is a bona fide occupational qualification. View the EEO is the Law poster.

If you are an individual with a disability and require a reasonable accommodation to complete any part of the application process, or are limited in the ability or unable to access or use this online application process and need an alternative method for applying, you may contact mailbox_tas_recruit@humana.com for assistance.

Humana Safety and Security

Humana will never ask, nor require a candidate provide money for work equipment and network access during the application process. If you become aware of any instances where you as a candidate are asked to provide information and do not believe it is a legitimate request from Humana or affiliate, please contact mailbox_tas_recruit@humana.com to validate the request.

If you are a California resident and would like to review our California Consumer Privacy Act (CCPA) Policy click here :

Keywords: Humana, Louisville , Clinical Pharmacy Lead, Other , Louisville, Kentucky

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