Medicaid Drug Strategy Pharmacist Lead

About the Role

Employment Type: Full time

Become a part of our caring community and help us put health first. The Medicaid Drug Strategy Pharmacist Lead requires a broad understanding of pharmacy, managed care, PBM, market and regulatory insights to develop, and/or implement drug strategies to mitigate cost trend and improve health outcomes.

Responsibilities

The Medicaid Drug Strategy Pharmacist Lead work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.

• The Medicaid Drug Strategy Pharmacist Lead uses clinical and financial data driven methods to develop and influence drug strategies for the Medicaid lines of business.
• Utilizes broad understanding of pharmacy, managed care, PBM, market and regulatory insights to support the development of Medicaid formulary and medical drug strategies to mitigate Humana’s costs and trend while improving our member’s health outcomes and costs.
• Help facilitate and provide transparency to informed formulary and medical drug decisions made consistent with our formulary guiding principles and Medicaid state requirements.
• Translates information from multiple sources to clearly communicate a compelling clinical, data-driven message to executive-level audiences on our drug strategies.
• Works across multiple departments to support formulary and medical drug strategy development and decisions.
• Works with appropriate business partners to ensure accurate and timely implementation and maintenance of Humana driven Medicaid drug strategy decisions.
• Leverages market trends and competitive intel insights to support the development of strategies.
• 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.

Key Competencies

• Acts Strategically: Has vision, anticipates future consequences and trends accurately; has broad knowledge and perspective; creates competitive and breakthrough strategies and plans.
• Builds Trust: You honor your word by doing what you say you are going to do.
• 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.
• Innovates: Introduces or develops new ideas and processes which improve performance or productivity.
• Implementation/Execution: You are good at organizing and managing multiple priorities and/or projects by using appropriate methodologies and tools.
• 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.

Use your skills to make an impact.

Required Qualifications

• Pharmacy Degree from an accredited School of Pharmacy
• 3+ years of clinical experience in managed care or other pharmacy related field
• Experience in analysis and problem-solving
• Excellent oral and written communication skills, previous experience presenting and interacting with senior leadership
• Flexible, dynamic personality who works well in a team environment and is also an individual contributor
• Experience building out new processes and developing infrastructure for new processes.
• Ability to prioritize, organizes, and executes effective time management
• Ability to assimilate, analyze, draw conclusions, and make recommendations from complex data
• Ability to work in either a team or an individual capacity to achieve goals and meet deadlines
• Successful track record in facilitating and consulting across teams and managing projects
• Proficient in Microsoft Office products: Powerpoint, Excel, Word

Preferred Qualifications

• BPS Board Certification (any BPS certification)
• Pharmacy practice residency or similar pharmacy practice experience
• Knowledge of Medicaid as it relates to pharmacy
• Experience in Formulary development