Humana Medicare Segment Business Liaison Pharmacist - California or Nevada in Fresno, California

Role:Medicare Segment Business Liaison Pharmacist Assignment: Medicare Pharmacy Segment Support
Location:Work from home California or Nevada

This role supports the regional Humana Medicare Advantage Prescription Drug (MAPD) plan for all pharmacy activities. It does this through the following:

  • Primary focus of position is the pharmacy subject matter expert, supporting external partners (value based providers systems), and internal partners (Humana Inc. markets including, but not limited to MAPD lines of business).

  • Providing financial and utilization analysis to our internal Humana Inc. markets and external provider systems related to drug trend management

  • Participating in internal Humana Inc. divisional and regional committees and relevant operational meetings

  • Supporting providers with Part B/Part D performance metrics to ensure success as they move along the Path to Value risk continuum.

  • Provide clinical support to provider systems through operational and executive meetings and various quality provider meetings.

  • Provide markets/regions with relevant pharmacy related insight into CMS Medicare bid strategy

  • Creating a high level of engagement with the respective divisional/regional leadership/provider groups/ and Provider Engagement team leadership

  • Engaging the MAPD markets with Humana Pharmacy Solutions (HPS) programs and leading the pull-through of HPS initiatives

  • Identifying the new programs and industry best practices that could be considered as part of trends and best practices

  • Work with internal stakeholders to define appropriate messaging, strategy and data analysis for internal Humana Inc. markets and external provider systems

  • Provide expertise and support to internal Humana Inc. markets and external provider systems related to pharmacy quality and CMS STARS measures

Role Essentials

  • Degree in Pharmacy and current state licensure in good standing

  • Knowledge of pharmacy practice and cost drivers

Ability to work independently under general instructions and with a team Knowledgeable in MS applications (Word, Excel, Access, PowerPoint)

* 3 years or more of pharmacy experience, or equivalent residency experience withinHumana

  • Familiarity with Pharmacy utilization, spend and trend financial reporting and modeling, and strategy with providers and systems

  • Experience in a consultative or business setting having to interpret and communicate financial reporting and modeling Pharmacy utilization to others without a pharmaceutical background

    • Role Desirables *
  • MBA, or Pharmacy related business experience in and out of managed care environment

  • 3-4 years of experience specific to health plan, pharmaceutical, administrative, or other related business experience, or relevant pharmacy residency experience

  • Home Residence in California

    • Reporting Relationships *

    Reports directly to the specific Divisional Leader, Medicare Pharmacy Segment Support

    • Additional Information * Approximately 20-30% overnight travel (average 3-4 days a month)

    At Humana, we know your well-being is important to you, and it’s important to us too. That’s why we’re committed to making resources available to you that will enable you to become happier, healthier, and more productive in all areas of your life. If you share our passion for helping people, we likely have the right place for you at Humana.

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Title: Medicare Segment Business Liaison Pharmacist - California or Nevada

Location: CA-Los Angeles

Other Locations: US-CA-Fresno, US-NV-Las Vegas, US-CA-Torrance

Requisition ID: 189135

Humana Inc., headquartered in Louisville, Ky., is a leading health care company that offers a wide range of insurance products and health and wellness services that incorporate an integrated approach to lifelong well-being. By leveraging the strengths of its core businesses, Humana believes it can better explore opportunities for existing and emerging adjacencies in health care that can further enhance wellness opportunities for the millions of people across the nation with whom the company has relationships.

Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. We also provide free language interpreter services. See our full accessibility rights information and language options.