What are the responsibilities and job description for the Director, Clinical Pharmacy position at Humana?
**Description**
The Director, Clinical Pharmacy Drug Evaluation and Policy Strategies oversees drug class reviews/evaluation, clinical policy strategy development, research, P&T committee oversight, and accreditation. This position will work and collaborate with leaders across the Humana enterprise, HPS executive leaders, as well as have extensive engagement representing Humana with drug manufacturers and providers.
**Responsibilities**
The Director, Clinical Pharmacy Drug Evaluation and Policy Strategies requires a broad understanding of pharmacy, managed care, and specialty to develop and/or implement clinical strategies to mitigate cost while improving health outcomes. He/she requires an in-depth understanding of how organization capabilities interrelate across the function and segment.
**Responsibilities**
Leads Humana's Pharmacy and Therapeutics processes including overseeing clinical drug reviews, drug policy development and drug utilization management strategies
Leads a team of clinical pharmacists that serve as subject matter experts in assigned therapeutic areas
Promotes evidence-based medicine and total cost of care models in our pharmacy processes and formulary decisions
Works with appropriate business partners to ensure accurate and timely implementation of drug strategy decisions
Ensures that compliance standards set by regulators, URAC, and NCQA are defined and documented in Humana's policies and procedures, and processes are followed and audited
Works closely with our research and analytics teams to generate real-world evidence
Supports reviews of provider and member communications related to drug strategies
Participates in Humana committees as appropriate
Promotes a continuous process improvement mindset, with a focus on comprehensive process documentation and quality
Advocates for Humana's clinical drug strategies in internal and external forums
**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
8 years of clinical experience in managed care or equivalent experience
5 years of formulary and drug policy development experience or equivalent experience
5 years experience in effectively leading direct reports and cross-functional teams
Strong track record of driving solutions that achieved clinical and financial outcomes
Exceptional cross-functional collaboration, relationship management, influencing, and interpersonal skills
Impeccable oral and written communication skills, as well as the polish, poise, and executive presence to effectively interact with and present to external partners and executive and senior-level stakeholders
Very disciplined; has the ability to manage competing priorities and operate effectively within a large and complex organizational structure
Ability to engage, educate, influence and guide matrixed teams at all levels on the concepts, opportunities and strategy of managing traditional and specialty medications
Ability to influence and build relationships with people across all levels and organizations internally and externally
**Preferred Qualifications**
MBA, pharmacoeconomics or health outcomes training
Board Certified Pharmacist
Experience in finance and/or business-related pharmacy practice
**Additional Information**
Ability to travel approximately 10%
Must be able to work during core business hours, Monday-Friday 8AM-5PM EST
Humana and its subsidiaries require vaccinated associates who work outside of their home to submit proof of vaccination, including COVID-19 boosters. Associates who remain unvaccinated must either undergo weekly negative COVID testing OR wear a mask at all times while in a Humana facility or while working in the field.
To ensure Home or Hybrid Home/Office associates' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria:
At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested
Satellite, cellular and microwave connection can be used only if approved by leadership
Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job.
Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA 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 [ Link removed ] - Click here to apply to Director, Clinical Pharmacy
The Director, Clinical Pharmacy Drug Evaluation and Policy Strategies oversees drug class reviews/evaluation, clinical policy strategy development, research, P&T committee oversight, and accreditation. This position will work and collaborate with leaders across the Humana enterprise, HPS executive leaders, as well as have extensive engagement representing Humana with drug manufacturers and providers.
**Responsibilities**
The Director, Clinical Pharmacy Drug Evaluation and Policy Strategies requires a broad understanding of pharmacy, managed care, and specialty to develop and/or implement clinical strategies to mitigate cost while improving health outcomes. He/she requires an in-depth understanding of how organization capabilities interrelate across the function and segment.
**Responsibilities**
Leads Humana's Pharmacy and Therapeutics processes including overseeing clinical drug reviews, drug policy development and drug utilization management strategies
Leads a team of clinical pharmacists that serve as subject matter experts in assigned therapeutic areas
Promotes evidence-based medicine and total cost of care models in our pharmacy processes and formulary decisions
Works with appropriate business partners to ensure accurate and timely implementation of drug strategy decisions
Ensures that compliance standards set by regulators, URAC, and NCQA are defined and documented in Humana's policies and procedures, and processes are followed and audited
Works closely with our research and analytics teams to generate real-world evidence
Supports reviews of provider and member communications related to drug strategies
Participates in Humana committees as appropriate
Promotes a continuous process improvement mindset, with a focus on comprehensive process documentation and quality
Advocates for Humana's clinical drug strategies in internal and external forums
**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
8 years of clinical experience in managed care or equivalent experience
5 years of formulary and drug policy development experience or equivalent experience
5 years experience in effectively leading direct reports and cross-functional teams
Strong track record of driving solutions that achieved clinical and financial outcomes
Exceptional cross-functional collaboration, relationship management, influencing, and interpersonal skills
Impeccable oral and written communication skills, as well as the polish, poise, and executive presence to effectively interact with and present to external partners and executive and senior-level stakeholders
Very disciplined; has the ability to manage competing priorities and operate effectively within a large and complex organizational structure
Ability to engage, educate, influence and guide matrixed teams at all levels on the concepts, opportunities and strategy of managing traditional and specialty medications
Ability to influence and build relationships with people across all levels and organizations internally and externally
**Preferred Qualifications**
MBA, pharmacoeconomics or health outcomes training
Board Certified Pharmacist
Experience in finance and/or business-related pharmacy practice
**Additional Information**
Ability to travel approximately 10%
Must be able to work during core business hours, Monday-Friday 8AM-5PM EST
Humana and its subsidiaries require vaccinated associates who work outside of their home to submit proof of vaccination, including COVID-19 boosters. Associates who remain unvaccinated must either undergo weekly negative COVID testing OR wear a mask at all times while in a Humana facility or while working in the field.
To ensure Home or Hybrid Home/Office associates' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria:
At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested
Satellite, cellular and microwave connection can be used only if approved by leadership
Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job.
Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA 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 [ Link removed ] - Click here to apply to Director, Clinical Pharmacy
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