Lead Director, Strategic Planning & Execution
CVS HealthSalary not specified
- Full Time
- Expert & Leadership (9+ years)
Not SpecifiedCompensation
Senior (5 to 8 years)Experience Level
Full TimeJob Type
UnknownVisa
Healthcare, PharmaceuticalsIndustries
Requirements
Candidates should possess Pharmacy Benefits Manager (PBM) experience, expertise in pharmacy contracting, pricing, or adjudication including development, implementation, and maintenance, and proficiency in utilizing Microsoft Excel to analyze and interpret data. Strong financial acumen and the ability to manage multiple tasks with attention to detail are also required, along with the capacity to give direction and make sound business decisions.
Responsibilities
The Senior Pharmacy Contracting Professional will be responsible for reporting, implementing, and maintaining Humana’s Healthy Horizon Medicaid business, ensuring contract compliance, and performing analysis regarding pharmacy claims and network composition to identify contracting needs. They will oversee pharmacy network setups and maintenance, generate reports, and collaborate with internal business partners to ensure compliance with state Medicaid requirements. The role involves making decisions on complex issues related to project components and exercising considerable latitude in determining objectives and approaches to assignments, while also potentially requiring travel for training or meetings.
Skills
Pharmacy Benefits Manager (PBM)
Pharmacy contracting
Pricing
Adjudication
Microsoft Excel
Data analysis
Financial analysis
Network management
Regulatory compliance
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.
Key Metrics
Louisville, KentuckyHeadquarters
1961Year Founded
IPOCompany Stage
Social Impact, HealthcareIndustries
10,001+Employees