Humana

Senior Clinical Programs Pharmacist

San Antonio, Texas, United States

Not SpecifiedCompensation
Senior (5 to 8 years), Expert & Leadership (9+ years)Experience Level
Full TimeJob Type
UnknownVisa
Health Insurance, PharmaceuticalsIndustries

Employment Details

Employment Type: Full time

About the Role

Become a part of our caring community and help us put health first. The Senior RX Clinical Programs Pharmacist integrates programs developed to improve overall health outcomes with a focus on prescription drugs.

The Senior RX Clinical Programs Pharmacist work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. The Senior RX Clinical Programs Pharmacist oversees medication therapy, strategy on comprehensive medication reviews, and prescription drug optimization in cases where patients are taking multiple medications. Drives health awareness with patients through Rx Education and targeted quarterly campaigns. Places outbound calls to confirm patients are taking drugs and provides counseling. Begins to influence department’s strategy. 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.

Use your skills to make an impact.

Required Qualifications

  • Bachelor of Science in Pharmacy or PharmD Degree
  • Active pharmacist license in the state(s) in which you are required to practice
  • Strong organizational skills and ability to stay on schedule
  • Proven problem-solving and troubleshooting skills
  • Ability to work independently and within a team setting to achieve goals and meet deadlines.
  • Excellent verbal and written presentation skills with ability to communicate effectively across all levels of the organization
  • Ability to take initiative, ability to manage multiple or competing priorities, and work in a fast-paced environment
  • Comprehensive knowledge of Microsoft Office applications, including Word, PowerPoint & Excel
  • Must be passionate about contributing to an organization focused on continuously improving consumer experiences

Preferred Qualifications

  • Previous experience with pharmacy benefits management
  • Previous Commercial, Medicare and/or Medicaid experience
  • 3 or more years clinical experience in managed care
  • Ability to manage end-to-end-processes
  • Understand Humana's business processes, systems, tools, regulations and structure and how they interrelate to provide products and services that create value for Humana members
  • Previous management experience and ability to lead teams
  • Previous program or project management experience
  • Proven success in leading teams (both direct and indirect) with multiple accountabilities
  • Excellent data analysis and experience working with Access, SQL and Excel
  • Lean, 6 sigma experience and/or certification

Additional Information (Work-at-Home Requirements)

  • Internet: Must have the ability to provide a high-speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense. A minimum standard speed for optimal performance of 25x10 (25mbps download x 10mbps upload) is required. Satellite and Wireless Internet service is NOT allowed for this role.
  • Workspace: A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Important Information

Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from Humana@myworkday.com with instructions on how to add the information into your official application on Humana’s secure website.

As part of our hiring process for this opportunity, we may contact you via text message and email to gather more information using a software platform called HIreVue. If you are selected to move forward from your application prescreen, you may receive correspondence inviting you to participate in a Text Messaging interview. Your recorded interview will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.

Skills

Pharmacy
Medication Therapy Management
Clinical Pharmacy
Patient Counseling
Health Outcomes
Problem-Solving
Organizational Skills
Microsoft Office Suite
Communication

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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