Staff Clinical Pharmacist - Drug Policy Mgmt

Profile

Description

The Staff Clinical Pharmacist is an integral part of the Clinical Drug Policy Management team which ensures synchronization of formulary utilization management policies across multiple systems. Humana is seeking a positive and proactive individual to contribute to this high performing team which drives clinical and operational execution of Humana's clinical drug policies.

Responsibilities

Responsible for the creation, maintenance, and clinical oversight of clinical tools which help facilitate clinical medication reviews.

Responsible for operationalizing prior authorization criteria into Humana systems in alignment with Humana's Pharmacy and Therapeutics Committee decisions.

Responsible for developing clinical protocols for automated prior authorization decision making.

Responsible for providing clinically sound recommendations as it relates to Humana clinical review guidance.

Active participant in Humana's formulary and Pharmacy and Therapeutics processes.

Pharmacy subject matter expert as it relates to Humana's prior authorization review system.

Key Competencies:

Acts Strategically : Has vision, anticipates future consequences and trends accurately; has broad knowledge and perspective; creates competitive and breakthrough strategies and plans.

Leads Change : Models agility, adaptability and an openness to new ways of thinking and operating. Guides and energizes others to embrace new opportunities arising from change. Inspires strong organizational performance through periods of transformation, ambiguity, and complexity.

Leads Positively : Leads by example to cultivate a climate of motivation, positive energy and meaning in work. Empowers and guides associates to take personal responsibility, encouraging them to productively learn, flourish, and strengthen team capacity. Assesses, selects, recognizes, and develops diverse talent to capitalize on competencies, ideas and passions.

Drives for Excellence: You are a continuous learner who encourages others to learn. By constantly upgrading your own work, you achieve results and outperform the competition

Builds Trust : You honor your word by doing what you say you are going to do

Collaborates: Engages others by gathering multiple views and being open to diverse perspectives, focusing on a shared purpose that puts Humana's overall success first. Develops and strengthens networks and relationships, both inside and outside the organization, that support company performance. Proactively and transparently contributes information and energy toward creating value with others.

Implementation/Execution: You are good at organizing and managing multiple priorities and/or projects by using appropriate methodologies and tools. Develops and optimizes end-to-end processes

Problem Solving: You are a problem solver with the ability to encourage others in collaborative problem solving. Acting as both a broker and consultant regarding resources, you engage others in problem solving without taking over.

Required Qualifications

Degree of Doctor of Pharmacy (PharmD or RPh) from an accredited School of Pharmacy

Active, unrestricted pharmacy licensure

Strong process improvement and project management skills

Demonstrates delivery of business results

Excellent verbal and written communication skills

Able to give direction and make sound business decisions

Ability to assimilate, analyze, draw conclusions, and make recommendations from complex data

Flexible, dynamic personality who works well in a team environment and is also an effective individual contributor

Preferred Qualifications

Completion of Managed Care Pharmacy Residency

MBA

Board Certified Pharmacotherapy Specialist

Six Sigma, Lean (or other quality program) background

Three years' experience in pharmacy benefits management and Medicare Part D

Medicaid experience

Previous management experience and ability to lead teams

Strong organizational skills

Excellent verbal and written communication skills

Scheduled Weekly Hours

40

Company info

Humana Inc.
Website : http://www.humana.com