Senior Program Manager, Clinical Performance and Innovation
Twin HealthSalary not specified
- Full Time
- Senior (5 to 8 years)
Not SpecifiedCompensation
Senior (5 to 8 years)Experience Level
Full TimeJob Type
UnknownVisa
Healthcare, Pharmaceuticals, Managed CareIndustries
Requirements
Candidates must possess a pharmacy degree from an accredited school of pharmacy, maintain an active Pharmacist license with the Board of Pharmacy in the appropriate state, and have clinical experience in managed care or a related field. They should also be able to conduct clinical reviews assessing for appropriate automation opportunities and recommend drug utilization tools.
Responsibilities
The Senior Clinical Pharmacist will support government program strategies, evaluate drug policies for automation opportunities, provide government program and clinical automation support, develop and maintain clinical strategies related to Drug Denial Lines (DL), Drug Auto Authorization Extension (AAE), Drug Medically Accepted Indication (MAI), Fast Pass (FP), Prior Authorization Hub (PAHub), and Non-Formulary Guide (NFG), participate in Humana’s formulary and Pharmacy and Therapeutics processes, act as a subject matter expert, conduct analysis on administrative costs and utilization trends, collaborate on research projects, develop corporate communications, support administrative costs and drug trend management, and make decisions on moderately complex to complex issues regarding project components.
Skills
Managed Care
PBM Knowledge
Drug Policy Evaluation
Automation Strategies
Utilization Management
Pharmacy Operations
Clinical Strategy Development
Formulary Management
Pharmacy and Therapeutics
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