Senior Clinical Pharmacist

🔥 15 minutes ago

🇺🇸 United States – Remote

💵 $126.3k - $173.7k / year

⏰ Full Time

🟠 Senior

💊 Pharmacist

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Humana

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1961

🏥 Healthcare

🛡️ Insurance

⚕️ Healthcare Insurance

Healthcare • Insurance • Healthcare Insurance

Humana is a healthcare company dedicated to making a positive impact on the health of individuals, communities, and the healthcare system as a whole. With a focus on putting health first, Humana serves a diverse range of populations, including seniors and the military, providing Medicare Advantage HMO, PPO, and PFFS plans. Humana is committed to fostering a culture of belonging and mutual respect, offering competitive and flexible benefits to ensure the financial security of its employees and their families. The company prides itself on creating an inclusive workplace where everyone has the opportunity to succeed.

📋 Description

• Provide clinical and operational leadership for Medicaid Medication Therapy Management (MTM) programs across multiple state markets • Translate state clinical objectives into effective MTM program designs • Ensure ongoing administration of Medicaid MTM programs • Serve as a clinical MTM subject-matter expert • Work closely with state market partners, vendors, and other stakeholders • Oversee program eligibility, clinical service design, reporting, budget management, and ongoing program performance • Establish and maintain program eligibility and CMR/TMR service design • Oversee program eligibility processes • Manage vendor relationships and program budgets • Coordinate required monthly, quarterly, and annual state reporting • Monitor evolving Medicaid requirements • Provide Quality Program oversight for Medicare and Medicaid MTM programs • Ensure program design aligns with state-specific requirements, contractual obligations, RFP commitments, and clinical goals • Report to an Associate Director

🎯 Requirements

• Active Pharmacist license with the Board of Pharmacy in the appropriate state of residence • Minimum one (1) year of experience in a Pharmacy setting • Proficiency with MS Office Suite • Ability to navigate multiple systems and platforms • Ability to troubleshoot general technical difficulties in a remote environment • Professional experience managing multiple projects and prioritizing as business needs change • Ability to work Monday through Friday, 8:00 AM - 5:00 PM Eastern Time • Ability to work from a dedicated space without ongoing interruptions to protect member PHI / HIPAA information • Home internet service with at least 25 Mbps download and 10 Mbps upload speed • PharmD preferred • Health Plan experience preferred • Knowledge of Medicaid as it relates to pharmacy preferred • Six Sigma and/or Project Management Professional certification preferred • Pharmacy practice residency or similar pharmacy practice experience preferred

🏖️ Benefits

• Bonus incentive plan based on company and/or individual performance • Medical, dental and vision benefits • 401(k) retirement savings plan • Paid time off • Company and personal holidays • Paid parental and caregiver leave • Short-term and long-term disability • Life insurance • Personal wellness and smart healthcare decision support • Occasional travel to Humana offices for training or meetings may be required

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