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Job Details

Senior Pharmacy Clinical Advisor - PDP Pharmacy Stars

Company name
Humana Inc.

Location
Aberdeen, SD, United States

Employment Type
Full-Time

Industry
Project Management, Healthcare, Pharmaceutical

Posted on
Apr 21, 2023

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Profile

Description

The Senior Pharmacy Clinical Advisor is an integral part of the Pharmacy Stars team which is accountable for Humana's medication related Star measure performance. The Senior Pharmacy Clinical Advisor develops strategies to improve PDP plan quality, is the enterprise subject matter expert for medication related Star measures, and is responsible for ideation, implementation, and execution of new PDP focused initiatives. The Senior Pharmacy Clinical Advisor exercises independent judgment and decision making on complex issues regarding job duties and related tasks, works under minimal supervision, and analyzes variable factors to determine the best course of action.

Responsibilities

Responsibilities:

Develops clinical and business strategies designed to improve PDP plan quality and Star ratings.

Enterprise subject matter expert for medication related Star measures (measure specifications, industry trends, CMS guidance, etc.).

Collaborates with analytics associates to project how initiatives will impact quality and Star ratings.

Collaborates with MAPD clinical leads to identify strategic and programmatic synergies

Collaborates with multidisciplinary teams and key stakeholders across the enterprise to develop relationships, define business scope, and implement innovative programs.

Presents confidently to senior leadership on key metrics - financial, operational, and clinical

Responsible for program engagement, collaboration with vendors, and maintenance of effective working relationships resulting in achievement of goals and performance metrics.

Responsible for financial management of the program budget.

Required Qualifications:

Pharmacy Degree from an accredited School of Pharmacy

Clear and active Pharmacist license in the state(s) in which you are required to practice

2 years of clinical experience in managed care or pharmacy related field, or equivalent

Proficiencies in Microsoft Office applications (especially Word, Excel, and PowerPoint)

Preferred Qualifications:

Previous experience in quality measure performance

Master's Degree in Business, Healthcare Administration, or related field

Accredited Pharmacy Practice Residency

2 years in project management or leadership experience

#LI-Remote

Additional Information

Interview Format:

As part of our hiring process for this opportunity, we will be using an exciting interviewing technology called Modern Hire to enhance our hiring and decision-making ability. Modern Hire allows us to quickly connect and gain valuable information for you pertaining to your relevant skills and experience at a time that is best for your schedule.

If you are selected, you will receive correspondence inviting you to participate in a Modern Hire assessment. You will have a set of questions and you will provide responses to each question. You should anticipate this to take about 15 - 20 minutes. Your answers will be reviewed and you will subsequently be informed if you will be moving forward to next round.

Alert: Humana values personal identity protection. Please be aware that applicants selected for leader review may be asked to provide a social security number, if it is not already on file. When required, an email will be sent from Humana@myworkday.com with instructions to add the information into the application at Humana's secure website.

According to Humana's COVID-19 policy, vaccination and masking is required regardless of vaccination status (with exception for eating and drinking) for associates working in a clinical setting where patients receive care (e.g., pharmacy retail locations, clinics, home care). The policy only requires the primary series alone (first and second vaccine). Boosters are encouraged, but not required. Associates have the option to request an accommodation for medical, religious or other personal needs.

Please note: Some areas of our business, such as the Primary Care Organization including CenterWell, Conviva, Kindred at Home, onehome, SeniorBridge, Neighborhood Centers, Pharmacy Distribution Centers and others, may be required to adhere to federal, state or local or additional workplace guidelines

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 https://www.humana.com/legal/accessibility-resources?source=Humana_Website.

Company info

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

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