Associate Vice President, Pharmacy Stars and Provider Engagement

Humana

1d • Hybrid

About The Position

As a company whose primary focus is on the well-being of its members, Humana is dedicated to shifting perceptions of the health insurance industry. We believe our role goes beyond that of a provider to that of a well-being partner who will empower consumers to live a life that’s healthy, active and rewarding. In order to fulfill that mission, we’ve launched a search focused on identifying a talented and influential leader to lead our Pharmacy Stars and Provider Engagement Team. Humana is seeking a proven healthcare executive focused on leadership, culture and strategic business development with extensive quality measure performance experience. Demonstrated ability to define vision and strategy, drive transformation, achieve objectives, attract, develop and retain top talent. This leader will work and collaborate with leaders across the Humana enterprise, Humana Pharmacy Solutions executive leaders as well as partner incredibly closely with our broader Stars leadership team. This role is responsible for leading an organization with a mission to improve our members health outcomes via optimized medication use. The right candidate exemplifies a balanced approach of business acumen and deep clinical knowledge and optimizes his/her resources by building a culture of accountability, high performance, and collaboration. In addition, this leader will utilize a broad understanding of managed care and PBM practice to develop, implement, and optimize strategies and programs to driver best in class quality measure performance and provider engagement.

Requirements

• 5+ years of experience in managed care or equivalent experience
• 2+ years of quality measure experience or equivalent experience
• 5+ years of leadership experience
• Strong track record of driving solutions that achieved clinical and financial outcomes
• Complex and innovative problem-solving, analytical, critical and strategic thinking capabilities; knows how to create options and then converge on solutions
• Exceptional cross-functional collaboration, relationship management, influencing, and interpersonal skills
• 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
• Able to articulate vision, mobilize teams, and deliver results
• Strong delegation and decision-making skills
• Success in leading teams- effectively coaching, developing and leading, including direct-reports and matrixed functions
• Impeccable oral and written communication skills, as well as the polish, poise, and executive presence to effectively interact with and present to executives, external partners, and senior-level stakeholders

Nice To Haves

• MBA, MPH, or health outcomes research training
• Board Certified Pharmacotherapy Specialist
• Six Sigma, Lean (or other quality program) background
• Registered pharmacist; Degree of Doctor of Pharmacy

Responsibilities

• Owns the clinical program strategy for Pharmacy Stars quality measure performance, including end-to-end Pharmacy Stars strategy and execution. This is inclusive of ongoing innovation to drive improvement in existing measures, preparation for measures on display and a commitment to ongoing performance improvement.
• Partners and collaborates with executive level leaders in the Retail organization to align programmatic and experience driven strategies to improve Stars performance.
• Serves as a key point of contact between our Medicare Stars team, and Retail Clinical Strategy team and pharmacy; partners beyond the patient safety domain to drive Stars performance across the enterprise.
• Supports our Opioid focused clinical programs.
• Drives our Medication Therapy Management (MTM) strategy, delivering value and operational efficiency via strong vendor management.
• Oversite of pharmacy provider engagement strategy; driving Stars performance and optimization of medication therapy for Humana plan members.
• Serves as a relationship owner externally for Pharmacy Quality Alliance- a key organization that influences CMS for quality measures that become part of the Stars program
• Leads vendor strategy to drive performance and operational efficiency across all clinical programs.
• Leads retail pharmacy partnership strategy to drive performance
• Partners closely with Retail and Centerwell partners to drive enterprise value and health outcomes.
• Invests in the growth and development of associates.
• Integrates across the broader pharmacy organization to amplify the enterprise value of pharmacy.
• Prepare executive level communications, speaking to team performance and enterprise collaboration
• Effectively manages program budget

Benefits

• medical benefits
• dental benefits
• 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 disability
• long-term disability
• life insurance
• bonus incentive plan

What This Job Offers

• Job Type: Full-time
• Career Level: Executive
• Education Level: No Education Listed
• Number of Employees: 5,001-10,000 employees