[Remote] Pharmacy Director at Humana

Michigan, United States

Not SpecifiedCompensation

N/AExperience Level

N/AJob Type

Not SpecifiedVisa

N/AIndustries

Requirements

Bachelor’s degree in Pharmacy or Doctor of Pharmacy (PharmD)
Michigan-licensed pharmacist residing or willing to relocate to Michigan
Minimum of ten plus years of Pharmacy Experience
At least three years’ experience in managed care and/or PBM operations
Ability to travel 10% of time
Successful track record in facilitating and consulting across teams and managing projects
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
Master’s degree in public health, Business Administration or a related field (preferred)
Board Certified Specialty Pharmacist (preferred)
Experience with Microsoft Access & Microsoft Project (preferred)
Experience with data analytics (preferred)

Responsibilities

Monitors drug development pipeline and medical literature
Provides clinical support for internal stakeholders
Develops and/or implements strategies and programs to mitigate cost trend and improve health outcomes
Plans, directs, and monitors all financial, operational, professional, and clinical activities for pharmacy program development
Ensures the pharmacy department provides optimal pharmaceutical services that meet all legal, accreditation, and certification requirements
Coordinates day-to-day pharmacy operations with the plan Chief Executive Officer and Chief Medical Officer
Keeps current with State and Federal regulations regarding the practice of Pharmacy and implements changes as necessary
Develops corporate communications to be shared with senior leadership
Supports trend management by conducting analysis of drug spend, utilization, and/or approval scenarios
Advises executives on matters of significance
Exercises independent judgment and decision making on complex issues
Facilitates and consults across teams and managing projects
Manages the Humana Michigan FIDE-SNP health plan relationship with the internal PBM
Represents Humana at Pharmacy Medicaid meetings, including those with the Michigan Department of Health and Human Services (MDHHS)

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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