Medicaid Pharmacy Director

Hiring By - Biostaffic


Job Highlights

Not Disclosed

Remote Job

Posted 4 months ago
Job details
Become a part of our caring community and help us put health first
The Clinical Pharmacy Lead monitors drug development pipeline, and medical literature, while providing clinical support for internal stakeholders. 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 Pharmacy Lead works on problems of diverse scope and complexity ranging from moderate to substantial.
The Medicaid Pharmacy Director, internally known as a Clinical Pharmacy Lead, Plans, directs, and monitors all financial, operational, professional, and clinical activities for the purposes of pharmacy program development. Implements policies and procedures that ensure the pharmacy department provides optimal pharmaceutical services that meet all legal, accreditation, and certification requirements. Keeps current with State and Federal regulations regarding the practice of Pharmacy and implements changes as necessary to maintain compliance supporting both the business and public relations strategies. Collaborates on research projects and develops proposals for research projects. Develops corporate communications to be shared with senior leadership. Supports trend management by conducting analysis of drug spend, utilization, and/or approval scenarios. Advises executives to develop functional strategies (often segment specific) on matters of significance. Exercises independent judgment and decision making on complex issues regarding job duties and related tasks, and works under minimal supervision. Uses independent judgment requiring analysis of variable factors and determining the best course of action.
Required Qualifications
Use your skills to make an impact
  • Bachelors of Pharmacy or a Doctor of Pharmacy (PharmD)
  • Must have an active Pharmacist license with the Board of Pharmacy and reside in the state of licensure.
  • Must represent Humana at all meetings of the State's Drug Utilization Review (DUR) Board
  • In-depth knowledge and at least 3-5 years demonstrated experience in managed care/managed pharmacy/competitive environment, and/or completion of managed care residency
  • Successful track record in facilitating and consulting across teams and managing projects
  • Thrives in a fast paced, multi-project work environment while still ensuring attention to detail
  • Excellent communication skills, both oral and written
  • Proficiency in Microsoft Word, Excel, & PowerPoint
  • Expertise in working collaboratively and communicating with staff in different positions and all levels of management positions
Preferred Qualifications
  • Pharm D
  • Master's Degree in Business Administration or a related field
  • Experience with Microsoft Access & Microsoft Project
  • Experience with pharmacy benefits and health benefits
Additional Information:
"This is a hybrid position"
Prefer candidate reside in Columbia, SC or has ability to commute to the Columbia, SC office.
Additional Information
Interview Format:
As part of our hiring process for this opportunity, we will be using an interviewing technology called Modern Hire to enhance our hiring and decision-making ability. Modern Hire allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.
To Ensure Home Or Hybrid Home/Office Employees’ Ability To Work Effectively, The Self-provided Internet Service Of Home Or Hybrid Home/Office Employees Must Meet The Following Criteria:
At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested.
Satellite, cellular and microwave connection can be used only if approved by leadership.
Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.
Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.
Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from with instructions on how to add the information into your official application on Humana’s secure website.
Scheduled Weekly Hours
About Us
Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
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.

Benefits Offered?

  • No

Bonus Offered?

  • No

Travel Required?

  • No

Remote Job:

  • Yes

Global Experience Needed?

  • No

Specialized Experience Needed?

  • No

Apply before:

  • Apr 13, 2024
Company Overview

Current Openings: 0

Humana will never ask, nor require a candidate to provide money for work equipment and network access during the application process. If you become aware of any instances where you as a candidate are asked to provide information and do not believe it is a legitimate request from Humana or affiliate, please contact to validate the request At Humana, our cultural foundation is aligned to helping members achieve their best health by delivering personalized, simplified, whole-person healthcare experiences. Recognizing healthcare needs continue to evolve for each person, for each family and for each community, Humana continuously creates innovative solutions and resources that help people live their healthiest lives on their terms –when and where they need it. Our employees are at the heart of making this happen and that’s why we are dedicated to building an organization of dynamic talent whose experience and passion center on putting the customer first.
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