[Remote] Senior Pharmacy Contracting Professional at Humana

San Antonio, Texas, United States

Humana Logo
Not SpecifiedCompensation
N/AExperience Level
N/AJob Type
Not SpecifiedVisa
N/AIndustries

Requirements

  • Bachelor's Degree
  • 5+ years of experience in pharmacy contracting, pharmacy benefit management, or a closely related field
  • 5+ years of experience in pharmacy contracting
  • Ability to manage multiple tasks and deadlines with attention to detail

Responsibilities

  • Conduct all aspects of pharmaceutical contracting and pricing including development, implementation, and maintenance
  • Oversee relationships with Humana pharmacy partners
  • Support pharmacies throughout the contracting process
  • Address daily inquiries from pharmacy partners
  • Facilitate the collection of required compliance documentation
  • Assist with new Medicaid contract implementations

Skills

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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