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The Clinical Pharmacist Lead utilizes broad understanding of managed care and PBM knowledge to develop, and/or implement strategies and programs to mitigate cost trend and improve health outcomes. The Clinical Pharmacist Lead works on problems of diverse scope and complexity ranging from moderate to substantial. This includes analyzing complex pharmacy spend issues, identifying trends, forecasting utilization management effectiveness, and developing innovative cost-saving strategies. The ideal candidate will have a strong analytical background, excellent presentation skills, a keen interest in pharmacy economics, with experience in data analysis and financial modeling. They will translate clinical data into financial insights, present findings to executives, and collaborate with cross-functional teams to optimize cost management.

The Clinical Pharmacist Lead within the Pharmacy and Medical Trend team plays a crucial role in analyzing and managing pharmacy spend to ensure cost-effective medication utilization for our members. The Clinical Pharmacist Lead will be responsible for forecasting utilization management effectiveness, identifying trends, analyzing complex problems related to pharmacy spend and developing innovative solutions for savings calculations. This role requires strong analytical skills, a deep understanding of pharmacy economics, and the ability to present findings to senior leadership effectively. This person exercises independent judgment requiring analysis of variable factors and determining the best course of action.

Key Responsibilities:

• Analyze complex pharmacy spend problems, identify trends, and determine causes and effects.

• Forecast the effectiveness of utilization management in converting to preferred products or preventing inappropriate drug usage.

• Develop innovative methods for calculating savings and optimizing cost management strategies.

• Present analyses and findings to executives, anticipating questions and providing clear, concise explanations.

• Collaborate with clinical subject matter experts to translate clinical information into financial forecasts and communicate these insights to actuaries.

• Collaborate with cross-functional teams to develop and implement cost-saving initiatives.

• Stay current with industry trends and regulatory changes affecting pharmacy economics.

• Demonstrate curiosity and a proactive approach to understanding the economic impact of pharmacy trends.

Use your skills to make an impact

Required Qualifications:

• PharmD from an accredited institution.

• Active pharmacist license with the Board of Pharmacy in state of residence

• Proven experience in analyzing pharmacy spend and identifying trends.

• Strong skills in forecasting, data analysis, and financial modeling.

• Ability to develop innovative solutions for cost management and savings calculations.

• Excellent presentation skills, with experience presenting to executive-level audiences.

• Ability to think on your feet and anticipate potential questions or concerns.

• Strong interest in the economics of pharmacy and healthcare.

• Ability to translate clinical data into financial insights for forecasting purposes.

• Excellent communication and collaboration skills.

• Proficiency in relevant software and data analysis tools.

• Expertise in working collaboratively and communicating with staff in different positions and all levels of management positions.

Preferred Qualifications

• Managed Care Residency Training

• Board Certification

• Master's Degree in Business Administration or a related field

• Experience with Medicare

• Experience with pharmacy benefit manager utilization management practices

Scheduled Weekly Hours

40

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.$123,800 - $170,400 per yearThis job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, 'Humana') offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides 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 and many other opportunities.

About us

About CenterWell Pharmacy: CenterWell Pharmacy provides convenient, safe, reliable pharmacy services and is committed to excellence and quality. Through our home delivery and over-the-counter fulfillment services, specialty, and retail pharmacy locations, we provide customers simple, integrated solutions every time. We care for patients with chronic and complex illnesses, as well as offer personalized clinical and educational services to improve health outcomes and drive superior medication adherence.About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation's largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first - for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one.

Equal Opportunity Employer

It is the policy of  Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or because he or she is a protected veteran. It is also the policy of  Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our https://www.humana.com/legal/accessibility-resources?source=Humana_Website.