Formulary And Medical Strategies Senior Professional

Profile

Description

The Senior Professional collaborates with healthcare professionals, pharmacists, and other business functions to implement formulary and medical strategies for the Medicaid line of business. 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.

Responsibilities

Responsibilities

The Senior Professional collaborates with healthcare professionals, pharmacists, and other business functions to implement formulary and medical strategies for the Medicaid line of business.


Utilizes broad understanding of pharmacy, managed care, PBM, market and regulatory insights to support the implementation of formulary and medical strategies to mitigate Humana's costs and trend while improving our member's health outcomes and costs.
Performs formulary and medical drug list data analysis and reporting that assist in the decision making of Medicaid drug strategies.
Works across multiple departments to support quarterly Medicaid drug list changes for member communications.
Prepares presentations to executive-level audiences on our Medicaid strategies.
Works with appropriate business partners to ensure accurate and timely implementation of formulary and medical strategies.
Develops key performance indicators and plans to drive overall process improvements and efficiency for the Medicaid line of business.
Serves as a key representative for Medicaid strategies across the organization.
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.


Required Qualifications


Bachelor's degree or equivalent
3 years of experience in managed care or other pharmacy related field
3 years of experience of leading successful implementation of projects
3 years of technical experience required for data analysis and reporting
Experience in analysis and problem-solving
Excellent oral and written communication skills, previous experience presenting and interacting with senior leadership
Flexible, dynamic personality who works well in a team environment and is also an individual contributor
Ability to prioritize, organizes, and executes effective time management
Ability to assimilate, analyze, draw conclusions, and make recommendations from complex data
Ability to work in either a team or an individual capacity to achieve goals and meet deadlines
Successful track record in facilitating and consulting across teams and managing projects
Comprehensive knowledge of all Microsoft Office applications, including Excel, Word, Powerpoint, Project, and Visio.


Preferred Qualifications


Master's degree
Knowledge of Medicaid business as it relates to pharmacy or medical drugs
Experience in finance and/or business-related pharmacy practice
Lean certification or Six Sigma Black belt


Additional Information

Scheduled Weekly Hours

40

Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ****

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