Humana
Overview
Join to apply for the
Medicare-Medicaid Pharmacy Director
role at
Humana . Base pay range:
$126,300.00/yr - $173,700.00/yr . The Pharmacy Director, internally known as a Clinical Pharmacy Lead, plans, directs, and monitors all financial, operational, professional, and clinical activities for pharmacy program development for our Fully Integrated Dual Eligible Special Needs Plan (FIDE-SNP) Michigan Medicare - Medicaid health plan. The individual leverages a broad understanding of managed care and pharmacy benefit management (PBM) to develop and implement strategies and programs that drive trends and improve health outcomes. This position will coordinate day-to-day pharmacy operations directly with the plan Chief Executive Officer and Chief Medical Officer. Responsibilities
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. 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. Works under minimal supervision, using independent judgment requiring analysis of variable factors and determining the best course of action. Facilitates and consults across teams and managing projects working collaboratively and communicating with staff in different positions and all levels of management positions. Manages the Humana Michigan FIDE-SNP health plan relationship with our internal PBM, Humana Pharmacy Solutions ensuring compliance with programmatic requirements, such as claims processing, prior authorization, formulary management and clinical programming. Represents Humana at all Pharmacy Medicaid meetings including those with the Michigan Department of Health and Human Services (MDHHS). Required Qualifications
Bachelor’s degree in Pharmacy or Doctor of Pharmacy (PharmD) Michigan-licensed pharmacist residing or willing to relocate to Michigan Minimum of ten plus years of Pharmacy Experience with at least three years’ experience in managed care and/or PBM operations Ability to travel 10% of time 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 Experience working collaboratively and communicating with staff in different positions and all levels of management positions Preferred Qualifications
Master’s degree in public health, Business Administration or a related field Board Certified Specialty Pharmacist Experience with Microsoft Access & Microsoft Project Experience with data analytics Additional Information
As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue 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. 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 required; 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. EEO Information
Humana is an Equal Opportunity Employer. It is Humana’s policy 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. The policy includes affirmative action as required by law. Other Details
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. Scheduled Weekly Hours: 40 About Us: Humana Inc. (NYSE: HUM) is committed to putting health first – for teammates, customers and the company. We offer a range of health and welfare benefits to support you and your family. This description includes an Equal Opportunity Employer statement. Referrals increase your chances of interviewing at Humana. Get notified about new Director of Pharmacy jobs in Michigan, United States.
#J-18808-Ljbffr
Join to apply for the
Medicare-Medicaid Pharmacy Director
role at
Humana . Base pay range:
$126,300.00/yr - $173,700.00/yr . The Pharmacy Director, internally known as a Clinical Pharmacy Lead, plans, directs, and monitors all financial, operational, professional, and clinical activities for pharmacy program development for our Fully Integrated Dual Eligible Special Needs Plan (FIDE-SNP) Michigan Medicare - Medicaid health plan. The individual leverages a broad understanding of managed care and pharmacy benefit management (PBM) to develop and implement strategies and programs that drive trends and improve health outcomes. This position will coordinate day-to-day pharmacy operations directly with the plan Chief Executive Officer and Chief Medical Officer. Responsibilities
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. 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. Works under minimal supervision, using independent judgment requiring analysis of variable factors and determining the best course of action. Facilitates and consults across teams and managing projects working collaboratively and communicating with staff in different positions and all levels of management positions. Manages the Humana Michigan FIDE-SNP health plan relationship with our internal PBM, Humana Pharmacy Solutions ensuring compliance with programmatic requirements, such as claims processing, prior authorization, formulary management and clinical programming. Represents Humana at all Pharmacy Medicaid meetings including those with the Michigan Department of Health and Human Services (MDHHS). Required Qualifications
Bachelor’s degree in Pharmacy or Doctor of Pharmacy (PharmD) Michigan-licensed pharmacist residing or willing to relocate to Michigan Minimum of ten plus years of Pharmacy Experience with at least three years’ experience in managed care and/or PBM operations Ability to travel 10% of time 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 Experience working collaboratively and communicating with staff in different positions and all levels of management positions Preferred Qualifications
Master’s degree in public health, Business Administration or a related field Board Certified Specialty Pharmacist Experience with Microsoft Access & Microsoft Project Experience with data analytics Additional Information
As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue 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. 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 required; 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. EEO Information
Humana is an Equal Opportunity Employer. It is Humana’s policy 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. The policy includes affirmative action as required by law. Other Details
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. Scheduled Weekly Hours: 40 About Us: Humana Inc. (NYSE: HUM) is committed to putting health first – for teammates, customers and the company. We offer a range of health and welfare benefits to support you and your family. This description includes an Equal Opportunity Employer statement. Referrals increase your chances of interviewing at Humana. Get notified about new Director of Pharmacy jobs in Michigan, United States.
#J-18808-Ljbffr