1+ months

Pharmacy Contracting Lead

Humana
Chattanooga, TN 37404
Description Humana is seeking a pharmacy contracting leader with proven ability to deliver results while ensuring an optimal patient experience. The Pharmacy Contracting Lead is responsible for leading a team of pharmacy network contracting professionals who secure Humana Pharmacys participation in third-party payer networks. In this role, you will champion Humana Pharmacy relationships with PBMs and government programs paving the way for pharmacy growth and profitability Responsibilities The ideal candidate will be able to apply a deep knowledge of drug pricing and analytical capabilities to guide the contracting strategy and protect the best interest of the patients we serve as well as the profitability of Humana Pharmacy. You will need to understand department, segment and organizational strategy and operating objectives including their impacts to related areas. Strong working knowledge of pharmacy reimbursement dynamics and service offerings is required. The pharmacy contracting leader will exercise independent judgment and decision making on complex issues regarding job duties and related tasks, and works under minimal supervision, use independent judgment requiring analysis of variable factors and determining the best course of action. Responsibilities include the following. + Lead a team of contracting professionals to execute agreements with third party payers for network participation + Champion Humana Pharmacy relationships with PBMs and other third party payers + Provide strategic guidance to senior leaders to set business strategies which facilitate pharmacy growth, profitability, and clinical integration + Oversee financial, operational and delivery aspects of pharmacy payer contracts + Oversee hiring, training and coaching of contracting professionals + Assess reimbursement rates and terms and monitor pharmacy profitability and performance + Manage all contracting and network management processes to optimize efficiencies + Monitor network performance and reimbursement including identification of incorrect payments, DIR reconciliation and quality network performance + Provide input to new business proposals and business reviews + Maintain excellent standing with government programs through risk mitigation and process controls Required Qualifications + Two years of pharmacy supply chain management or related experience with two years of managed care/payer contracting experience + Bachelors degree in Business Administration or related field + Candidate must demonstrate strong negotiating skills + Knowledge of pharmacy reimbursement terms and drug pricing dynamics + Excellent communication (verbal and written) skills is required + Extensive knowledge of retail, mail order and specialty pharmacy products and services + Must be results-driven and goal-orientated + Experience setting budgets and collaborating on financial modeling + Two years of leadership experience in the pharmacy or pharmacy benefits manager setting + Strong financial acumen with proficiency in analyzing and interpreting data + Ability to manage multiple tasks and deadlines with attention to detail + Ability to communicate effectively and deliver presentations to senior management. + Able to give direction and make sound business decisions + Must be passionate about contributing to an organization focused on continuously improving consumer experiences + Associates working in the state of Arizona must comply with the Tobacco Free Hiring Policy and upon offer will be subjected to nicotine testing as part of a 10-panel drug test Preferred Qualifications + Master's degree in Business or Healthcare Administration + Lean Six Sigma Certification + Specialty pharmacy leadership experience + CPA or CFA Additional Information + As part of our hiring process for this opportunity, we may contact you via text message or email to gather more information using a software platform called Modern Hire. Modern Hire offers On-Demand Text, Voice and Video screenings that allow you to interact with us at the time and location most convenient for you. Your recorded responses will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews. 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 <>

Categories

Posted: 2020-09-04 Expires: 2020-11-15

Before you go...

Our free job seeker tools include alerts for new jobs, saving your favorites, optimized job matching, and more! Just enter your email below.

Share this job:

Pharmacy Contracting Lead

Humana
Chattanooga, TN 37404

Join us to start saving your Favorite Jobs!

Sign In Create Account
Powered ByCareerCast