Associate Director, Formulary Operations Management
New
H
HumanaPharmacy benefits
United States, Eastern Time business hoursFull-TimeDirector
Salary$126,300 - $173,700 per year
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Job Details
- Experience
- 6 or more years of healthcare, pharmacy benefit management (PBM), managed care, health plan, formulary, pharmacy operations, or related experience; 2 or more years of leadership, management, project leadership, or people leadership experience
- Required Skills
- Project ManagementMicrosoft ExcelPowerPoint
Requirements
- Bachelor's degree.
- At least 6 years of healthcare, pharmacy benefit management (PBM), managed care, health plan, formulary, pharmacy operations, or related experience.
- At least 2 years of leadership, management, project leadership, or people leadership experience.
- Experience leading cross-functional initiatives involving multiple stakeholders.
- Strong analytical, problem-solving, and critical-thinking skills.
- Strong organizational and project management skills, including the ability to manage multiple priorities and deadlines.
- Excellent verbal and written communication skills, including executive-level communication.
- Comprehensive knowledge of Microsoft Office applications, including Excel, PowerPoint, Word, and Teams.
- Demonstrated ability to influence and drive organizational outcomes.
- For home-based work, provide internet service with at least 25 Mbps download and 10 Mbps upload and a dedicated workspace that protects member PHI/HIPAA information.
- Occasional travel to Humana offices for training or meetings may be required.
Responsibilities
- Lead formulary development and maintenance activities across applicable products and lines of business.
- Coordinate operational implementation of formulary changes with clinical, configuration, product, and operational teams.
- Support the development and execution of utilization management programs, including prior authorization, step therapy, and quantity limits.
- Evaluate formulary performance and operational impacts through data analysis and reporting.
- Ensure compliance with applicable state, federal, and client formulary requirements.
- Develop and maintain policies, procedures, and supporting documentation for formulary operations.
- Partner with stakeholders on formulary submissions, audits, regulatory reviews, and implementations.
- Lead projects related to formulary optimization, operational excellence, and process improvement.
- Lead and develop the team through clear expectations, coaching, and career development support.
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