Humana Clinical Pharmacy Lead (NC) - Group Medicare in Lancaster, South Carolina
This role supports the Humana Group Medicare (EGWP) plans for all pharmacy activities. The Clinical Pharmacy Lead will be responsible for providing consultative Account Management Pharmacy Support for key assigned clients. They will leverage a broad understanding of managed care, Pharmacy Benefits and Clinical Products to implement strategies to drive trend and improve health outcomes. The Clinical Pharmacy Lead will deliver quarterly/annual account reviews of pharmacy financial information, utilization metrics and quality performance. This is a Work At Home (WAH) position, supporting North Carolina, that requires travel to meet with assigned clients.
Primary focus of position is the pharmacy subject matter expert, supporting internal partners (Humana Pharmacy Solutions, Group Medicare Sales and Account Management team) and external partners (Employer Groups).
Providing full service account management for the Humana Senior Products Medicare division for all pharmacy-related needs
Providing financial and utilization analysis related to pharmacy trends and collaborating with Group Medicare leadership on managing and understanding drivers of pharmacy utilization and spend.
Providing expertise for annual pharmacy benefit planning and readiness activities
Work with internal stakeholders to define appropriate messaging, strategy, and data analysis for internal Group Medicare team and external clients
Provide expertise and support to internal Group Medicare team and external clients related to pharmacy quality measures
Support meaningful adoption of pharmacy /clinical products with in Group Medicare; influencing clients to use our products and/or optimize the performance of the product
Identify clinical needs and pharmacy product opportunities within Group Medicare and communicate them to Clinical Product Organization (CPO) Leadership team
Collaborate with product leaders to provide input to pharmacy product development based on client feedback
PharmD degree or Bachelor of Science degree in Pharmacy from a college accredited by the American Council on Pharmaceutical Education (ACPE)
Active Pharmacy license, and in good standing
Minimum three (3) years of PBM experience
Minimum three (3) years of experience in Group Medicare or Commercial Account Management
Experience writing /reviewing RFP responses and performing formulary comparisons based on disruption analysis
Knowledge of pharmacy practice and the cost drivers of pharmacy
Familiarity with Pharmacy utilization, spend and trend financials
Successful track record in facilitating and consulting across teams and managing projects
Experience managing multiple priorities, multiple accounts /projects
Ability to work independently under general instructions and with a team
Ability to develop cross functional relationships across multiple operational departments
Excellent communication skills, both oral and written
Strong analytical skills to interpret utilization metrics and deliver meaningful message to clients
Ability to draft, prepare and deliver presentations
Proficiency in Microsoft Applications including Word, Excel, & Power Point
Approximately 30% overnight travel required
Advanced Microsoft Excel skills
Proficiency with Microsoft Access & Microsoft Project
Experience with pharmacy benefits and health benefits management
Scheduled Weekly Hours
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 email@example.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 firstname.lastname@example.org to validate the request.