Become a part of our caring community and help us put health first

Be a part of an interactive team with broad exposure and scope within Humana. Humana is seeking a positive and proactive individual to contribute to a high performing team that drives innovation and strategies which optimize clinical outcomes, member experience and total cost of care. This role will be integral in ensuring adherence to regulatory and compliance standards for our Pharmacy and Therapeutics Committee.

The Senior Pharmacy Clinical Advisor analyzes and measures the effectiveness of existing business processes and develops sustainable, repeatable and quantifiable business process improvements. This role will collaborate with key internal Pharmacy partners, Program Clinical Leads, Senior Clinical Pharmacists, and manage external relationships.

The Senior Pharmacy Clinical Advisor work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors to determine the best course of action. Work is performed independently and without explicit direction. Exercises considerable latitude in determining objectives and approaches to assignments.

The Senior Pharmacy Clinical Advisor manages all aspects of a project, from start to finish, so it is completed on time and within budget. Moreover, the advisor is responsible for all administrative and compliance responsibilities for the Pharmacy and Therapeutics Committee. The advisor ensures that the efforts of multiple cross-functional project teams responsible for specific work streams are working in an integrated manner to optimize the experience and ensure timely completion of key milestones.

The advisor must be proficient in all stages of project development including technology integration, data management, and scope development and management. The advisor must have an in-depth understanding of business strategy, departments and segments organizational strategy and operating objectives, including their linkages to related areas.

The advisor is responsible for scheduling, facilitating, drafting and executing meeting agendas and presentations as appropriate and/or assigned.

The advisor establishes checks and balances to ensure compliance and quarterly business reviews and report outs. The advisor makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and received guidance where needed. The advisor will follow established guidelines/procedures.

Partner with Clinical Leads, Senior Clinical Pharmacists, Quality Professionals and other individuals as appropriate to drive long term strategic planning through the project management methodologies (initiation, planning, execution, control, and closing).

Maintain timelines, determine requirements and feasibility.

Understanding of the Quality Network Program - measures, mechanics, business stakeholders.

Identify gaps and opportunities to gain process, system, and member experience efficiencies while ensuring all regulatory and compliance standards.

Facilitate collaboration among stakeholders to define business requirements, resolve risks, define mutual goals, discuss reporting needs, strategic initiatives and improvements.

Create detailed project design and development documents and task-level project plans to organize cross-functional teams from strategy to implementation launch.

Conduct meetings, prepare meeting minute reports to communicate the status of the program, review issues, establish Service Level Agreements (SLAs), implement change request(s) and any other items as warranted.

Ensure documented organizational project policies and procedures are followed.

Identify areas of opportunity for and create new policy and procedures.

Assist with ROI analyses, program level budgets and program level reporting and metrics.

Responsible for the creation and management of the Clinical Drug Evaluation and Policy Strategies Team's quality program.

Research best business practices within and outside the organization to establish benchmark data and platforms for process improvement.

Collects and analyzes process data to initiate, develop and recommend business practices and procedures that focus on enhanced safety, increased productivity and reduced cost.

Determines how new information technologies can support re-engineering business processes.

Skills will be leveraged to ensure appropriate methods for benchmarking, business process analysis and re-engineering, change management and measurement, and/or process-driven systems requirements are utilized.

Influence our organization strategies with an eye towards repeatedly processes which allow for scaling of future initiatives.

Presents confidently to senior leadership on all matters related to process improvement and quality.

Works effectively with multiple internal areas including, but not limited to, clinical strategies, clinical programs, compliance, risk and quality

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.

Capacity Planning : Determines the requirements of a system, process, or work unit. Plans, analyzes and optimizes capacity to satisfy business requirements, predicts and mitigates constraints, plans enhancements to existing systems, processes or work unit capacity, and determines necessary resources required to provide adequate stability and performance in the most cost effective manner

Use your skills to make an impact

Required Qualifications

Bachelor's degree or equivalent

5+ years of technical healthcare experience

Strong analytical skills

Skilled in using data to identify areas of concern and drive operational changes

Successful track record in facilitating and consulting across teams and managing projects

Demonstrated ability to implement projects/campaigns and achieve business goals

Excellent computer skills including Microsoft Word, Outlook, Excel and PowerPoint

Must be passionate about contributing to an organization focused on continuously improving consumer experiences

Exceptional oral and written communications skills, including preparing and presenting information to executive-level audiences

Proven ability to perform complex data analysis that are relevant to business needs

Flexible, dynamic personality who works well in a team environment and can lead a project

Preferred Qualifications

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

Project Management experience (PMP a plus)

Six Sigma or Green Belt

Deep knowledge of Humana's operations and its mission, values, priorities, and culture

Additional Information:

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

SSN Statement: Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from [email protected] with instructions on how to add the information into your official application on Humana's secure website

o ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:

WAH Statement:

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

Employees 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 employees 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

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.$84,600 - $116,300 per yearThis job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, 'Humana') offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides 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 and many other opportunities.

About us

Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.

Equal Opportunity Employer

It is the policy of  Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or because he or she is a protected veteran. It is also the policy of  Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

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.