1+ months

Associate Director, Pharmacy Clinical Formulary and Medical Strategies

Humana
Louisville, KY 40207
Description The Associate Director, Pharmacy Clinical Formulary and Medical Strategies requires a broad understanding of pharmacy, managed care, and specialty to develop and/or implement clinical strategies to mitigate cost while improving health outcomes. He/she requires an in-depth understanding of how organization capabilities interrelate across the function and segment. The role requires a clinician and an effective operator to execute on the formulary and medical drug strategies. Responsibilities Responsibilities + Utilize broad understanding of pharmacy, managed care and specialty to develop strategies to mitigate Humanas cost and trend while improving our members health outcomes and costs + Lead Humanas formulary and medical drug strategy and Pharmacy and Therapeutics processes + Oversee clinical drug reviews and therapeutic class reviews + Oversee drug formulary and medical drug coverage strategies + Oversee drug clinical drug policy development and utilization management strategies + Lead pharmacy clinical subject matter experts + Promote evidence based medicine and total cost of care models into our formulary and Pharmacy and Therapeutics processes + Work closely with our research and analytics teams to generate real-world evidence + Support creation of specific provider and member communications as needed + Support clinical programs that improve the quality and costs of pharmaceutical care for our members + Partners with clinical, business professionals, actuaries and operations in a team environment + Proactively develops of key opportunities leveraging insights, market trends, industry feedback to meet key objectives and leverages information to devise new or improved product offerings + Participates in Humana Pharmacy committees as appropriate + Promotes a continuous process improvement mindset, with a focus on comprehensive process documentation and quality. + Advocates for Humanas clinical formulary strategy in internal and external forums Key Competencies + 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. + Capacity Planning: Determines the requirements of a system, process, or work unit. Plans, analyzes and optimizes capacity to satisfy business requirements, predicts and mitigates constraints, plans enhancements to existing systems, processes or work unit capacity, and determines necessary resources required to provide adequate stability and performance in the most cost effective manner Required Qualifications + Eight years of leadership experience + Eight years of clinical experience in managed care or equivalent experience + Five years of formulary and drug policy development experience or equivalent experience + Registered pharmacist; Degree of Doctor of Pharmacy + Deep business and financial acumen + Strong track record of driving solutions that achieved clinical and financial outcomes + Demonstrates initiative with a results orientation, and is highly resourceful (stretches people and money; compresses time) + Experience with effectively coaching, developing and leading direct reports and cross-functional teams + Complex and innovative problem-solving, analytical, critical and strategic thinking capabilities; knows how to create options and then converge on solutions + Brings an organized, attention-to-detail approach (strong tactical execution) + Exceptional cross-functional collaboration, relationship management, influencing, and interpersonal skills + Impeccable oral and written communication skills, as well as the polish, poise, and executive presence to effectively interact with and present to external partners and executive and senior-level stakeholders + Very disciplined; has the ability to manage competing priorities and operate effectively within a large and complex organizational structure + Ability to engage, educate, influence and guide matrixed teams at all levels on the concepts, opportunities and strategy of managing traditional and specialty medications + Ability to influence and build relationships with people across all levels and organizations internally and externally Preferred Qualifications + MBA, Pharmacoeconomics or Health Outcomes training + Board Certified Pharmacotherapy Specialist + Experience in finance and/or business related pharmacy practice Required Qualifications + Bachelor's Degree + Must have an active license with the Board of Pharmacy in the appropriate state + More than two years of experience as a Manager + Able to give direction and make sound business decisions + Must be passionate about contributing to an organization focused on continuously improving consumer experiences Preferred Qualifications + PharmD Additional Information Scheduled Weekly Hours 40 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 thats 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. California Residents If you are a California resident and would like to review our California Consumer Privacy Act (CCPA) Policy click here: CA Resident Privacy Policy <>

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Posted: 2020-07-10 Expires: 2020-08-16

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Associate Director, Pharmacy Clinical Formulary and Medical Strategies

Humana
Louisville, KY 40207

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