Company name
Humana Inc.
Location
Louisville, KY, United States
Employment Type
Full-Time
Industry
Healthcare, Pharmaceutical
Posted on
May 15, 2021
Profile
Description
The Staff Clinical Pharmacist is an integral part of the Clinical Drug Policy Management team which ensures synchronization of formulary utilization management policies across multiple systems. Humana is seeking a positive and proactive individual to contribute to this high performing team which drives clinical and operational execution of Humana's clinical drug policies.
Responsibilities
Responsible for the creation, maintenance, and clinical oversight of clinical tools which help facilitate clinical medication reviews.
Responsible for operationalizing prior authorization criteria into Humana systems in alignment with Humana's Pharmacy and Therapeutics Committee decisions.
Responsible for developing clinical protocols for automated prior authorization decision making.
Responsible for providing clinically sound recommendations as it relates to Humana clinical review guidance.
Active participant in Humana's formulary and Pharmacy and Therapeutics processes.
Pharmacy subject matter expert as it relates to Humana's prior authorization review system.
Key Competencies:
Acts Strategically : Has vision, anticipates future consequences and trends accurately; has broad knowledge and perspective; creates competitive and breakthrough strategies and plans.
Leads Change : Models agility, adaptability and an openness to new ways of thinking and operating. Guides and energizes others to embrace new opportunities arising from change. Inspires strong organizational performance through periods of transformation, ambiguity, and complexity.
Leads Positively : Leads by example to cultivate a climate of motivation, positive energy and meaning in work. Empowers and guides associates to take personal responsibility, encouraging them to productively learn, flourish, and strengthen team capacity. Assesses, selects, recognizes, and develops diverse talent to capitalize on competencies, ideas and passions.
Drives for Excellence: You are a continuous learner who encourages others to learn. By constantly upgrading your own work, you achieve results and outperform the competition
Builds Trust : You honor your word by doing what you say you are going to do
Collaborates: Engages others by gathering multiple views and being open to diverse perspectives, focusing on a shared purpose that puts Humana's overall success first. Develops and strengthens networks and relationships, both inside and outside the organization, that support company performance. Proactively and transparently contributes information and energy toward creating value with others.
Implementation/Execution: You are good at organizing and managing multiple priorities and/or projects by using appropriate methodologies and tools. Develops and optimizes end-to-end processes
Problem Solving: You are a problem solver with the ability to encourage others in collaborative problem solving. Acting as both a broker and consultant regarding resources, you engage others in problem solving without taking over.
Required Qualifications
Degree of Doctor of Pharmacy (PharmD or RPh) from an accredited School of Pharmacy
Active, unrestricted pharmacy licensure
Strong process improvement and project management skills
Demonstrates delivery of business results
Excellent verbal and written communication skills
Able to give direction and make sound business decisions
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 effective individual contributor
Preferred Qualifications
Completion of Managed Care Pharmacy Residency
MBA
Board Certified Pharmacotherapy Specialist
Six Sigma, Lean (or other quality program) background
Three years' experience in pharmacy benefits management and Medicare Part D
Medicaid experience
Previous management experience and ability to lead teams
Strong organizational skills
Excellent verbal and written communication skills
Scheduled Weekly Hours
40
Company info
Humana Inc.
Website : http://www.humana.com