Humana Clinical Pharmacy Lead, Specialty Programs, Infusion, Remote in Birmingham, Alabama
Be a part of an interactive team with broad exposure and scope within Humana. Humana is seeking a positive and proactive individual to contribute to a high performing team that drives innovation and strategies which optimize clinical outcomes, member experience and total cost of care.
This individual will lead development of our clinical infusion strategy focused on our Medicare line of business. The overarching vision is to create programs which meet our members where they are to receive their specialty infusion medications. We believe the home has a unique value proposition as a site of care. Home-centric models can provide better patient experiences by delivering care to patients where they are, when they want it, in the place they feel most at ease.
In this role, you will collaborate closely with the current clinical pharmacy lead, specialty programs, infusion - commercial. Learning from the experience and programs in our commercial line of business and adapting them based on Medicare benefit design and clinical needs of the population.
Design innovative, high-touch clinical programs which aim to migrate our Medicare members to home for their infusion medications
Oversee and lead the Medicare site of care strategy development with value assessment, forecasting the savings of the strategy and tracking actual experience to projection.
Produce top quality presentations and reports to be shared with senior leadership such as program updates, and market event notifications
Lead the analysis and generation of insights related to infusible drugs and site of care opportunity to inform future infusion strategy.
Continuously monitors relevant publicly available news/developments in the pharmaceutical sector, performing any ad hoc analyses and generating insights, related to Medicare, infusion and site of care opportunity
Utilizes broad understanding of managed care, medical billing and clinical program development to drive efficiencies in the program, and growth of the strategy
Collaborate with pharmacists, business professionals and actuaries in a team environment, specifically collaborating closing with our pharmacy analytics team, the Clinical Pharmacy Leads for Medicare Trend, Formulary and Medical Strategies, Clinical Program Operations and Home Solutions leaders.
Present confidently to senior leadership on key metrics including Medicare infusion strategy and program performance
Work holistically with our operational partners to execute site of care and new strategies and continuously improve the process
Lead multidisciplinary meetings, embracing the keys of Essential Facilitation, to drive to alignment and results
Understands managed care and is capable of generating broad insights into the business
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
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
Degree of Doctor of Pharmacy (PharmD or RPh) from an accredited School of Pharmacy
Active, unrestricted pharmacy licensure
Three years clinical experience in managed care or pharmacy related field
Board Certified Pharmacotherapy Specialist (BCPS)
MBA, pharmacoeconomics or health outcomes training
Six Sigma, Lean (or other quality program) background
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 Medicare (MAPD and PDP) clinical strategies
Previous experience in trend analysis
Previous experience in medical claims analysis
Previous experience in clinical program development and leadership
Previous experience in home infusion and/or site of care strategies
Working knowledge of MS excel, MS PowerPoint required
COVID 19 Vaccination:
We will require full COVID vaccination for this job as we are a healthcare company committed to putting health and safety first for our members, patients, associates, and communities we serve.
If progressed to offer, you will be required to provide proof of full vaccination or documentation for a medical or religious exemption consideration where allowed by law. Requests for these exemptions should be submitted at least 2 week prior to your scheduled first day of work.
As part of our hiring process for this opportunity, we will be using an exciting interviewing technology called Modern Hire to enhance our hiring and decision-making ability. Modern Hire allows us to quickly connect and gain valuable information for you pertaining to your relevant skills and experience at a time that is best for your schedule.
If you are selected for a first round interview, you will receive an email/text correspondence inviting you to participate in a Modern Hire interview. In this interview, you will listen to a set of interview questions over your phone and you will provide recorded responses to each question. You should anticipate this interview to take about 15 minutes. Your recorded interview will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.
Alert: Humana values personal identity protection. Please be aware that applicants selected for leader review may be asked to provide a social security number, if it is not already on file. When required, an email will be sent from Humana@myworkday.com with instructions to add the information into the application at Humana's secure website.
Scheduled Weekly Hours
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