Humana

Lead Pharmacy Forecasting and Performance Insights

San Antonio, Texas, United States

Not SpecifiedCompensation
Junior (1 to 2 years)Experience Level
Full TimeJob Type
UnknownVisa
Healthcare, Pharmaceuticals, Health InsuranceIndustries

Lead Associate, Data Analytics and Reporting

Employment Type: Full-time Location Type: Remote Scheduled Weekly Hours: 40 Pay Range: $129,300 - $177,800 per year

Position Overview

Become a part of our caring community and help us put health first. We are seeking a talented and motivated Lead Associate to join our Data Analytics and Reporting team, supporting CenterWell Pharmacy. In this role, you will serve as the owner and primary developer of our pharmacy volume forecast model and will be responsible for identifying and developing hypotheses for potential drivers of variances from model expectations. This role will be responsible for working across teams, aligning with actuarial and finance partners on modeling methodologies and assumptions in order to drive pharmacy growth and provide insights to current trends and potential impacts of future changes. This position requires excellent analytical, technical, and communication skills, with a focus on developing technical models around the potential impact of various changes to our business and translating model results into the "so what" for non-technical business leaders.

Key Responsibilities

  • Serve as the primary developer and steward of the pharmacy volume forecast model, ensuring accuracy and continual improvement.
  • Lead cross-functional alignment with actuarial partners regarding mail order utilization expectations for CMS bid submissions.
  • Model and evaluate the impact of benefit design changes on pharmacy volume, providing actionable recommendations.
  • Present complex analytical findings and model outputs to senior leaders and non-technical stakeholders, focusing on clear data storytelling.
  • Develop and maintain advanced analytical tools and dashboards to track prescription volume, market share, retention, and benefit design outcomes.
  • Collaborate closely with teams across actuarial, finance, and marketing to ensure holistic and informed strategy development.
  • Maintain a deep understanding of Medicare Part D benefit design and regulatory changes to inform forecasting and scenario analysis.
  • Monitor actual performance against forecasts and identify key drivers of variances.
  • Engage with key leaders in developing business strategies and influencing top-level decisions across the organization.
  • Use your skills to make an impact.

Key Qualifications

  • Experience:
    • 5+ years of experience in advanced analytics, data modeling, and scenario analysis, preferably in the healthcare or pharmacy industry.
    • 3+ years of analytics project and/or team leadership.
    • Experience in more than two functions (e.g., modeling, pricing, rate filing, reporting & analysis, trending).
  • Technical Skills:
    • Demonstrated expertise in SQL or a similar programming language for data manipulation and analysis.
    • Advanced proficiency in Microsoft Excel.
  • Communication & Collaboration:
    • Strong data storytelling skills, with the ability to communicate complex results and insights to senior leaders and non-technical audiences.
    • Experience collaborating with both financial and actuarial teams and understanding actuarial and financial analytics concepts is highly desired.
    • Excellent written and verbal communication skills.
  • Work Ethic & Organization:
    • Ability to work independently and take ownership of major analytic initiatives.
    • Strong organizational skills, attention to detail, and the ability to manage multiple projects simultaneously.
  • Education & Certifications:
    • Bachelor’s degree in a quantitative, technical, or related field required; Master’s degree preferred.
    • FSA or ASA plus relevant advanced degree, recent or relevant work experience, and/or other relevant professional designation.
    • MAAA

Travel

While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Bonus Eligibility

This job is eligible for a bonus incentive plan.

Skills

Pharmacy forecasting
Data modeling
Analytical tools
Dashboard development
Scenario analysis
Model validation
Cross-functional collaboration
Regulatory knowledge (Medicare Part D)

Humana

Health insurance provider for seniors and military

About Humana

Humana provides health and well-being services, focusing on Medicare Advantage plans for seniors, military personnel, and communities. Their plans include HMO, PPO, and PFFS options, designed to improve health outcomes through comprehensive and flexible coverage. Humana's revenue comes from government contracts and member premiums, and they aim to maintain high renewal rates by offering quality service and competitive benefits. The company stands out by fostering a culture of inclusivity and belonging among its employees, while also ensuring accessibility for all members, including offering free language interpreter services. Humana's goal is to deliver value to its members through an extensive provider network and innovative health solutions.

Louisville, KentuckyHeadquarters
1961Year Founded
IPOCompany Stage
Social Impact, HealthcareIndustries
10,001+Employees

Risks

Potential over-reliance on AI could disrupt operations if systems fail or are compromised.
Rising medical costs and tightening Medicare reimbursements may strain financial performance.
Leadership change with new CEO Jim Rechtin could lead to strategic disruptions.

Differentiation

Humana is a leader in Medicare Advantage plans, focusing on seniors and military personnel.
The company emphasizes inclusivity, offering free language interpreter services for accessibility.
Humana leverages AI and cloud technologies through a partnership with Google Cloud.

Upsides

Humana's investment in Healthpilot enhances digital enrollment for Medicare options.
The company is the first insurer to cover TMS therapy for adolescent depression.
Humana's focus on value-based care aims to improve outcomes for kidney disease patients.

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