Director of RxEducation Operations

Humana • Mansfield, TX

246d • $168,000 - $231,000 • Remote

About The Position

Humana is seeking a Director of RxEducation Operations to lead our Pharmacy telephonic member education operation. This position will work to educate Humana plan members about the benefits of using CenterWell Mail Order Pharmacy. The primary goal of this position is to convert members to using CenterWell Pharmacy (CWP) by successfully showing the value proposition of our services (cost, quality, service, improved clinical outcomes, ease). The Director of RxEducation Operations oversees the enrollment, education, engagement, and activation duties for Humana plan members enrolling to use CWP. This position requires an in-depth understanding of how organization capabilities interrelate across the function or segment. This position contributes to business strategy by understanding benefit offerings to ensure enrollment success, identifying member education opportunities to drive maximum utilization of available resources, and directing clients on the use of available resources. Decisions are typically related to the implementation of new/updated programs or large-scale projects for the function and supporting technical/operational procedures and processes, and implements strategic plans, drives goals and objectives, and improves performance. Provides input into functions strategy.

Requirements

• Bachelor's degree
• Five or more years of leadership experience within an operations environment, with at least 2 of those being in a sales-focused team
• Demonstrated sales and account management experience
• Deep understanding of the Insurance and Pharmacy businesses
• Experience managing BPO operations and performance reviews across onshore, nearshore, and farshore teams, including contract oversight and P&L accountability
• Strong track record of driving solutions that achieved sales/operational and financial outcomes to include a background in trend analysis
• Experience with effectively coaching, developing and leading direct reports and cross-functional teams
• Exceptional cross-functional collaboration, relationship management, influence, 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 conversions
• Problem solver who can find viable solutions that meets business needs, absent from all ideal tools and resources

Nice To Haves

• Master's degree
• Experience with STAR and HEDIS quality initiatives
• Ability to work with project stakeholders and remote teams at all levels in the organization in a collaborative, team environment
• Ability to knowledge of new technology and business management concepts to improve operations
• Critical thinker who can anticipate team needs and take initiative to present ideas, ask the right questions and deliver the highest quality work

Responsibilities

• Leads an operational team of approximately 300 telephonic associates as well as a small leadership team, with the intent of educating members on CWP's services and driving member conversion to CWP mail order.
• Builds and designs the right metrics and a new rewards system for front-line associates, motivating the right behaviors to drive member conversion to CWP that results in increased scripts to the pharmacy.
• Analyzes and improves current call scripting for telephonic associates that covers key value proposition techniques, including consultative selling.
• Monitors script conversion metrics, proactively identifying areas for improvement with RxE (RxEducation) team.
• Leads a test lab for call process and scripting- testing different contact method approaches and language to determine most effective approach for prospective CWP members.
• Partners with RxE Implementation team, as well as shares best practices with Specialty RxE team.
• Participates in business reviews and performance planning with BPO partners across onshore, nearshore, and offshore operations; supports scalable delivery models that reduce cost and improve consistency.
• Leads the design and execution of outreach programs with a focus on strategy, resource planning, and value realization.

Benefits

• Medical, dental and vision benefits
• 401(k) retirement savings plan
• Paid time off, including company and personal holidays, volunteer time off, paid parental and caregiver leave
• Short-term and long-term disability
• Life insurance

What This Job Offers

• Job Type: Full-time
• Career Level: Director
• Industry: Insurance Carriers and Related Activities
• Education Level: Bachelor's degree