Senior Clinical Pharmacist

Become a part of our caring community and help us put health first
 

The Senior Clinical Pharmacist monitors drug development pipeline, and medical literature, while providing clinical support for internal stakeholders. Utilizes broad understanding of managed care and PBM knowledge to develop, and/or implement strategies and programs to mitigate cost trend and improve health outcomes. The Senior Clinical Pharmacist work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.

The Senior Clinical Pharmacist develops, maintains, and/or operationalizes formularies related to coverage, utilization management edits, or clinical coverage policies for pharmacy and medical administered drug products. Conducts analysis on drug utilization trends to evaluate and inform formulary strategies. Collaborates on research projects and develops proposals for research projects. Develops corporate communications to be shared with senior leadership. Supports trend management by conducting analysis of drug spend, utilization, and/or approval scenarios. Begins to influence department’s strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude in determining objectives and approaches to assignments.

This role identifies and analyzes potential sources of loss to minimize risk. The Senior Clinical Pharmacist estimates the potential financial consequences of an occurring loss. Develops and implements controls and cost-effective approaches to minimize the organization's risks.

Use your skills to make an impact
 

Additional Job Description

Required Qualifications

• Bachelor's degree
• Must have an active Pharmacist license with the Board of Pharmacy in the appropriate state
• Must be passionate about contributing to an organization focused on continuously improving consumer experiences

Preferred Qualifications

PharmD

• Humana Clinical Pharmacy Review (HCPR)-Strongly preferred
• Health Plan experience
• Knowledge of Medicare and/or Medicaid as it relates to pharmacy
• 1-3 years Compliance and/or Audit management experience
• Working understanding of federal regulations and guidance
• Previous operational and/or process experience related to prior authorizations and appeals desired
• Six Sigma and/or Project Management Professional certification
• Pharmacy practice residency or similar pharmacy practice experience

Interview Format:

As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.

Work at Home requirements:

To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:

At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested
Satellite, cellular and microwave connection can be used only if approved by leadership
Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.
Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

Scheduled Weekly Hours

40

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.

 

$112,400 - $154,900 per year

 

This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

About us
 

About CenterWell Pharmacy: CenterWell Pharmacy provides convenient, safe, reliable pharmacy services and is committed to excellence and quality. Through our home delivery and over-the-counter fulfillment services, specialty, and retail pharmacy locations, we provide customers simple, integrated solutions every time. We care for patients with chronic and complex illnesses, as well as offer personalized clinical and educational services to improve health outcomes and drive superior medication adherence.

About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation’s largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first – for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one.

Equal Opportunity Employer

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or veteran status. It is also the policy of Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.