Director Pharmacy Clinical Formulary and Medical Drug Strategies

Profile

Description

Humana is seeking an experienced management professional to lead an interactive team with broad exposure and scope within Humana. This position will work and collaborate with leaders across the Humana enterprise, HPS executive leaders as well as have extensive engagement representing Humana with external vendors, drug manufacturers and providers.

The 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

The 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


Utilize broad understanding of pharmacy, managed care and specialty to develop strategies to mitigate Humana's cost and trend while improving our member's health outcomes and costs
Lead Humana's 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 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 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 committees as appropriate
Promotes a continuous process improvement mindset, with a focus on comprehensive process documentation and quality.
Advocates for Humana's clinical formulary strategy in internal and external forums


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


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


Scheduled Weekly Hours

40

Company info

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