Clinical Pharmacy Lead

Profile

Description

The Clinical Pharmacy Lead (CPL) role supports the regional Humana Medicare Advantage Prescription Drug (MAPD) plan for all pharmacy activities and works on problems of diverse scope and complexity ranging from moderate to substantial. The CPL utilizes a 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 Clinical Pharmacy Lead monitors drug development pipeline, and medical literature, while providing clinical support for internal stakeholders.

Responsibilities

Location: work at home anywhere but preference for Illinois, Wisconsin, Minnesota, South Dakota, North Dakota

The Clinical Pharmacy Lead (CPL) role utilizes a broad range of deep Pharmacy expertise, experience and communication skills to support their assigned Region/territory. The CPL is aligned with, and an integral member of , Regional Stakeholder teams as well as Enterprise Teams and key external Provider Groups and deploys their skills in implementing strategies and programs to mitigate cost trend and improve health outcomes. The CPL Utilizes broad understanding of managed care and PBM knowledge to develop, and/ The Clinical Pharmacy Lead monitors drug development pipeline, and medical literature, while providing clinical support for internal stakeholders.

This role supports the regional Humana Medicare Advantage Prescription Drug (MAPD) plan for all pharmacy activities. In this role you will:


Primary focus of position is the pharmacy subject matter expert, supporting external partners (value based providers systems), and internal partners (**MEMBERS ONLY**SIGN UP NOW***. markets including, but not limited to MAPD lines of business).
Providing financial and utilization analysis to our internal **MEMBERS ONLY**SIGN UP NOW***. markets and external provider systems related to drug trend management
Participating in internal **MEMBERS ONLY**SIGN UP NOW***. divisional and regional committees and relevant operational meetings
Supporting providers with Part B/Part D performance metrics to ensure success as they move along the Path to Value risk continuum.
Provide clinical support to provider systems through operational and executive meetings and various quality provider meetings.
Provide markets/regions with relevant pharmacy related insight into CMS Medicare bid strategy
Creating a high level of engagement with the respective divisional/regional leadership/provider groups/ and Provider Engagement team leadership
Engaging the MAPD markets with Humana Pharmacy Solutions (HPS) programs and leading the pull-through of HPS initiatives
Identifying the new programs and industry best practices that could be considered as part of trends and best practices
Work with internal stakeholders to define appropriate messaging, strategy and data analysis for internal **MEMBERS ONLY**SIGN UP NOW***. markets and external provider systems
Provide expertise and support to internal **MEMBERS ONLY**SIGN UP NOW***. markets and external provider systems related to pharmacy quality and CMS STARS measures


Role Essentials


Bachelor's degree in Pharmacy
7 years or more of experience in pharmacy and/or consulting
Must have an active Pharmacist license with the Board of Pharmacy in the appropriate state
Successful track record in facilitating and consulting across teams and managing projects
Thrives in a fast paced, multi-project work environment while still ensuring attention to detail
Excellent communication skills, both oral and written
Proficiency in Microsoft Word, Excel, & PowerPoint
Expertise in working collaboratively and communicating with staff in different positions and all levels of management positions


Role Desirables


Pharm D
Master's Degree in Business Administration or a related field
Experience with Microsoft Access & Microsoft Project
Experience with pharmacy benefits and health benefits


Additional Information

Humana is an organization with careers that change lives-including yours. As an innovator in the fast-paced industry of healthcare, we offer our associates careers that challenge, support and inspire them to use their passion for helping others and to lead their best lives. If you're ready to help people achieve lifelong well-being, and be a part of an organization that is growing and poised to make an impact on the future of healthcare, Humana has the right opportunity for you.

Scheduled Weekly Hours

40

Company info

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