Humana

Senior Specialty Consultative Pharmacist

Ohio, United States

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

Senior Specialty Consultative Pharmacist

Employment Type: Full-time

Position Overview

Become a part of our caring community and help us put health first. The Senior Specialty Consultative Pharmacist integrates clinical programs to improve overall health outcomes with a focus on Specialty prescription medications filled at CenterWell Specialty Pharmacy. This role involves working with moderately complex to complex issues where in-depth evaluation of variable factors is required.

The primary responsibility will be to assess and evaluate the conditions of our members, with a particular emphasis on medication therapy, through telephonic interactions to ensure they achieve and maintain optimal wellness. You will develop and implement comprehensive care plans, monitor patient progress through regular assessments, and utilize advanced telecommunication systems to provide medication education. This position offers the opportunity to make a significant impact on the lives of patients with serious and rare health conditions within a supportive and professional environment.

Responsibilities

As a member of the Specialty Clinical Team, you can perform a variety of tasks based upon business need. Daily work assignments include both inbound and outbound calls to patients to discuss medication therapy, side effect management, and adverse event reporting when appropriate.

Additional tasks that are not directly phone call related include, but are not limited to:

  • Pharmacist Care Plan/Treatment Review
  • Review prescriptions for accuracy
  • Check for drug-drug interactions
  • Evaluate appropriateness of disease state, dosage, directions, and therapy
  • Utilize electronic resources and guidelines to assist in professional decision-making

Requirements

  • Pharmacy degree from an accredited college of pharmacy (Bachelor of Science or PharmD)
  • Active PHARMACIST license from Florida, Texas, Ohio or Arizona Board of Pharmacy
  • Candidate must reside and work within the state of Florida, Texas, Ohio or Arizona
  • 3 or more years of experience as a pharmacist in a high-volume retail, hospital, or mail-order pharmacy practice environment
  • Ability to participate in Federal prescription programs
  • Ability to work independently and within a team setting to achieve goals and meet deadlines
  • Proven problem-solving skills and strong ability to utilize resources for professional decision-making
  • Work ethic that is focused, accurate, and highly productive
  • Excellent verbal and written skills with the ability to communicate effectively within the team and to patients or caregivers
  • Proficient with computers and comfortable troubleshooting technology issues
  • Comprehensive knowledge of Microsoft Office applications, including Word, Excel, Outlook, and OneNote

Preferred Qualifications

  • Pharmacist Board Certification – Oncology, Specialty, Geriatric, Pharmacotherapy, Ambulatory
  • Proficient in Spanish (If applicable, please specify this on application/resume when applying)
  • Previous experience in a Specialty Pharmacy setting
  • Previous experience with pharmacy benefits management
  • Previous Commercial, Medicare, and/or Medicaid experience
  • Previous clinical experience in managed care

Additional Information

  • Location Type: Remote
  • Schedule:
    • 3 days a week between the hours of 10 a.m. - 6:30 p.m. EST
    • 2 days a week of closing shifts between the hours of 11:30 a.m. - 8 p.m. EST
    • (1) Friday closing shift of 11:30 a.m. - 8 p.m. every 3-4 months.
    • Holiday shifts are rotated based on business operational hours and coverage needs.
  • Mandatory overtime may be required due to business needs.

Skills

Clinical Pharmacy
Specialty Pharmacy
Medication Therapy Management
Care Plan Development
Patient Assessment
Telecommunication Systems
Medication Education
Drug-Drug Interaction Analysis
Electronic Health Records (EHR)
Adverse Event Reporting

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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