Senior Clinical Pharmacist, Therapeutic Subject Matter Expert

Position Overview

Become a part of our caring community and help us put health first. The Clinical Drug Evaluation and Policy Strategies Senior Clinical Pharmacist Therapeutic Subject Matter Expert monitors the drug development pipeline and medical literature, while providing clinical support for internal stakeholders. Utilizes a broad understanding of managed care and PBM knowledge to develop and/or implement strategies and programs to mitigate cost trends and improve health outcomes. The Therapeutic Subject Matter Expert Pharmacist work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.

Responsibilities

• Develops, maintains, and/or operationalizes strategies related to utilization management edits and/or clinical coverage policies for pharmacy and medically administered drug products.
• Influences the department’s strategy.
• Participates in Humana’s formulary and Pharmacy and Therapeutics processes.
• Completes clinical reviews, policy development, and recommends drug coverage and potential drug utilization tools to mitigate Humana’s cost and trend while improving our member’s health and costs.
• Serves as a clinical subject matter expert and provides clinical support across Humana.
• Conducts analysis on drug utilization trends to evaluate and inform formulary strategies.
• Collaborates on research projects and develops proposals for research projects.
• Develops corporate communications to be shared with senior leadership.
• Makes decisions on moderately complex to complex issues regarding the 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: Honors your word by doing what you say you are going to do.
• Drives for Excellence: Is 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: Is good at organizing and managing multiple priorities and/or projects by using appropriate methodologies and tools.
• Problem Solving: Is a problem solver with the ability to encourage others in collaborative problem solving. Acting as both a broker and consultant regarding resources, engages others in problem solving without taking over.

Use your skills to make an impact!

Required Qualifications

• Pharmacy degree from an accredited school of pharmacy.
• Must have an active Pharmacist license with the Board of Pharmacy in the appropriate state.
• BPS Board Certification (any BPS certification).
• Clinical experience in managed care or other pharmacy-related field.
• Less than 10% travel requirement, including visit(s) to the home office in Louisville, KY.

Preferred Qualifications

• Pharmacoeconomics and Health Outcomes training.
• Pharmacy practice residency or similar pharmacy practice experience.
• Knowledge of Medicare and Medicaid as it relates to pharmacy.
• Six Sigma and/or Project Management Professional certification.

Additional Information

Interview Format

As part of our hiring process for this opportunity, we will be using an exciting interviewing technology called Modern Hire to enhance our hiring and decision-making ability. Modern Hire allows us to quickly connect and gain valuable information pertaining to your relevant skills and experience at a time that is best for your schedule.

If you are selected for a first-round interview, you will receive an email/text correspondence inviting you to participate in a Modern Hire interview.