Senior Pharmacy Professional
Location
Wisconsin
Posted
5 days ago
Salary
$71.1K - $97.8K / year
Seniority
Senior
Job Description
Senior Pharmacy Professional
Humana
• Intake pharmacy-related issues from care management teams, independently research and determine solutions, and collaborate with others to implement resolutions. • Lead the Pharmacy Steering Committee, coordinating monthly meetings with market and enterprise pharmacy leadership, setting agendas, facilitating discussions, and conducting follow-up activities. • Be a consultant to care management regarding member pharmacy needs. • Participate in state and federal audits as a subject matter expert related to member eligibility. • Support transition activities with previous pharmacy benefit manager and other vendors, including prescription file transfers, rebate capture, data error resolution, and compliance with CMS and state requirements. • Identify pharmacy-related challenges and make recommendations for process improvement. • Analyze pharmacy utilization data, identify trends, and collaborate with leadership and associates to ensure appropriate referrals and interventions. • Exercise independent judgment to analyze variable factors using data from a variety of pharmacy sources. • Develop and utilize pharmacy-related policies, job aids, and training materials. • Partner with Quality Improvement and Care Management teams to monitor pharmacy Star and HEDIS initiatives.
Job Requirements
- Bachelor's degree
- 2 years of data analysis & problem-solving regarding process and workflow concepts
- 2 years of experience with pharmacy benefits management or pharmacy claims
- 2 years of demonstrated proficiency in MS Office applications including Excel, Word, PowerPoint, and Visio
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
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