Hybrid Formulary Operations Management Professional

at Humana

• Job title: Formulary Operations Management Professional
• Job type: Full Time
• Experience level: Mid level, Senior
• Salary: $65,000 - $88,600 per year
• Degree requirement: Bachelor's Degree
• Location requirements: Hybrid, United States

About the role

• Formulary Operations Professional managing clinical tools within Humana’s Clinical Drug Policy team. Creating processes and improving efficiency for formulary utilization management.

Responsibilities

• Be part of the Clinical Drug Policy Management team ensuring synchronization of formulary utilization management policies across multiple systems
• Create and maintain clinical tools to facilitate clinical medication review decision making
• Operationalize prior authorization criteria into Humana systems in alignment with Humana’s Pharmacy and Therapeutics Committee
• Develop key performance indicators and plans to improve overall process improvements and efficiency
• Make decisions regarding own work methods with minimal direction

Requirements

• Bachelor’s Degree or equivalent experience in a healthcare setting
• Working knowledge of all Microsoft Office applications, including Word, Access, and Excel
• Strong organizational skills
• Strong written and verbal communication skills
• Works well independently and within a team setting to achieve goals and meet deadlines
• Prior demonstrated experience with process improvement and documentation
• Proficiency in Power Platform, Power BI, Power Apps
• Six Sigma Green belt certification
• Three years’ experience in pharmacy benefits management
• Three years of experience in a health services or technical field

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
• many other opportunities