Medicare Formulary Strategy Pharmacist Lead

Humana

2d • $138,900 - $191,000 • Remote

About The Position

The Formulary Strategy Pharmacist Lead requires a broad understanding of pharmacy, managed care, PBM, market and regulatory insights to develop, and/or implement formulary strategies to mitigate cost trend and improve health outcomes. The Formulary Strategy Pharmacist Lead work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. The Formulary Strategy Pharmacist Lead uses clinical and financial data driven methods to develop and influence formulary strategies for Humana's Medicare line of business. Utilizes broad understanding of pharmacy, managed care, PBM, market and regulatory insights to support the development of formulary strategies to mitigate Humana’s costs and trend while improving our member’s health outcomes and costs. Help facilitate and make informed formulary decisions consistent with our formulary guiding principles and enterprise objectives. Translates information from multiple sources to clearly communicate a compelling clinical, data-driven message to executive-level audiences on our formulary strategies. Works across multiple departments to support formulary strategy development and decisions. Works with appropriate business partners to ensure accurate and timely implementation of formulary decisions. Leverages market trends and competitive intel insights to support the development of formulary strategies.

Requirements

• Pharmacy Degree from an accredited School of Pharmacy
• Minimum of 3+ years of experience in managed care, health plan pharmacy, PBM, or related pharmacy environment
• Demonstrated knowledge of Medicare Part D (formularies, benefit design, regulatory considerations)
• Strong analytical and problem-solving skills, with the ability to evaluate complex data and make sound, timely decisions
• Demonstrated ability to synthesize detailed data into actionable insights while maintaining a clear understanding of broader strategic objectives
• Proven ability to communicate effectively across audiences, including developing and delivering presentations to senior/executive leadership
• Excellent written and verbal communication skills, with the ability to clearly articulate formulary strategy and rationale
• Strong collaboration skills, with a track record of influencing and consulting across cross-functional teams
• Demonstrated project management capabilities, including prioritization, organization, and execution in a fast-paced environment
• Self-motivated and adaptable, with the ability to work independently and within a team to meet deadlines and achieve goals
• Advanced proficiency in Microsoft Excel and PowerPoint, including the ability to analyze large datasets and translate findings into clear, actionable presentations

Nice To Haves

• MBA or other advanced business-related degree
• BPS Board Certification
• Completion of a pharmacy residency or equivalent advanced practice experience
• Direct experience with formulary development, strategy, or management in a health plan or PBM setting

Responsibilities

• Develop and/or implement formulary strategies to mitigate cost trend and improve health outcomes.
• Use clinical and financial data driven methods to develop and influence formulary strategies for Humana's Medicare line of business.
• Support the development of formulary strategies to mitigate Humana’s costs and trend while improving member’s health outcomes and costs.
• Facilitate and make informed formulary decisions consistent with formulary guiding principles and enterprise objectives.
• Translate information from multiple sources to clearly communicate a compelling clinical, data-driven message to executive-level audiences on formulary strategies.
• Work across multiple departments to support formulary strategy development and decisions.
• Work with appropriate business partners to ensure accurate and timely implementation of formulary decisions.
• Leverage market trends and competitive intel insights to support the development of formulary strategies.

Benefits

• 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

What This Job Offers

• Job Type: Full-time
• Career Level: Senior
• Education Level: High school or GED