Clinical Pharmacy Advisor Lead Trend

Profile

Description

The Clinical Pharmacy Advisor lead, overseeing Humana Pharmacy and Medical Trend, is a dynamic role within Humana. We are seeking a positive and proactive individual to contribute to a high performing team that helps translate the clinical into financial. The goals is to help ensure Humana profitability while improving our member's health and costs. This role functions in a highly collaborative environment across multiple departments to drive results.

This individual will lead medical and pharmacy trend review and the identification of trend bender strategies.

Responsibilities

Responsibilities include the following:

Utilize broad understanding of managed care to develop strategies to mitigate Humana's medical and pharmacy cost and trend while improving our member's health and costs.

Developing concrete trend mitigation opportunities from abstract information and concepts

Own the medical and pharmacy trend monitoring process including month over month, quarter over quarter and year over year medical trend review.

Lead trend management by conducting and analyzing drug spend, utilization and market share.

Lead the analysis and generation of insights related to medical and pharmacy trend to inform future trend-mitigation strategy.

Produce top quality presentations and reports to share with senior leadership such as trend updates, and market event notifications.

Continuously monitor relevant publicly available news/developments in the pharmaceutical sector, performing any ad hoc analyses and generating insights.

Collaborate with a multidisciplinary team in order to evaluate potential initiatives.

Collaborate with pharmacists, business professionals and actuaries in a team environment.

Present confidently to senior leadership on key metrics and trend.

Support clinical research integration activities with internal research department.

Lead multidisciplinary meetings, embracing the keys of Essential Facilitation, to drive to alignment and results.

Role Requirements and Competencies

Experience drawing conclusions and generating action from abstract asks

Confident in rapidly reprioritizing and adapting to business needs

Understands managed care and is capable of generating broad insights into the business

Self-directed

Accountable to financial goals and a history of delivering business results

Ability to influence others to achieve goals and meet deadlines

Strong critical thinking skills

Ability to see connections across large organizations

Works well independently and within a team setting to achieve goals and meet deadlines

Demonstrates initiative and the ability to multi-task and prioritize assignments

Ability to lead initiatives or projects

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

Very strong presentation skills

Able to produce clear, concise documentation

Positive and proactive

Additional Job Description

Required Qualifications

Clinical degree (e.g. Pharm. D.)

Three years clinical experience in managed care or pharmacy related field

Experience in managing the strategic planning cycle for a large organization with cross-functional engagement and prioritization

Experience executing complex strategic and operational initiatives

Problem-solving and project management skills

Previous experience in trend analysis

Excellent oral and written communication skills, previous experience presenting and interacting with senior leadership

Flexible, dynamic personality with a demonstrated ability to lead and influence others without authority while contributing individually

Previous experience in medical claims analysis

Working knowledge of MS excel, MS PowerPoint required

Preferred Qualifications

Board Certified Pharmacotherapy Specialist (BCPS)

MBA, pharmacoeconomics or health outcomes training

Six Sigma, Lean (or other quality program) background

Scheduled Weekly Hours

40

Company info

Humana Inc.
Website : http://www.humana.com