Lead Medicare Formulary Strategy Pharmacist

Role Overview

• require a broad understanding of pharmacy, managed care, PBM, market and regulatory insights to develop, and/or implement formulary strategies
• involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors
• use clinical and financial data driven methods to develop and influence formulary strategies for Humana's Medicare line of business
• support the development of formulary strategies to mitigate Humana’s costs and trend while improving our member’s health outcomes and costs
• facilitate and make informed formulary decisions consistent with our formulary guiding principles and enterprise objectives
• translate information from multiple sources to clearly communicate a compelling clinical, data-driven message to executive-level audiences on our formulary strategies
• work across multiple departments to support formulary strategy development and decisions
• collaborate with appropriate business partners to ensure accurate and timely implementation of formulary decisions
• leverage market trends and competitive intel insights to support the development of formulary strategies

Requirements

• Pharmacy Degree from an accredited School of Pharmacy
• Minimum of 3+ years of experience in managed care, health plan pharmacy, PBM, or related pharmacy environment
• Demonstrated knowledge of Medicare Part D (formularies, benefit design, regulatory considerations)
• Strong analytical and problem-solving skills, with the ability to evaluate complex data and make sound, timely decisions
• Demonstrated ability to synthesize detailed data into actionable insights while maintaining a clear understanding of broader strategic objectives
• Proven ability to communicate effectively across audiences, including developing and delivering presentations to senior/executive leadership
• Excellent written and verbal communication skills, with the ability to clearly articulate formulary strategy and rationale
• Strong collaboration skills, with a track record of influencing and consulting across cross-functional teams
• Demonstrated project management capabilities, including prioritization, organization, and execution in a fast-paced environment
• Self-motivated and adaptable, with the ability to work independently and within a team to meet deadlines and achieve goals
• Advanced proficiency in Microsoft Excel and PowerPoint, including the ability to analyze large datasets and translate findings into clear, actionable presentations

Benefits

• medical, dental and vision benefits
• 401(k) retirement savings plan
• time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave)
• short-term and long-term disability
• life insurance