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Director, Pharmacy Stars

Humana

Humana

Remote
Posted on Wednesday, June 26, 2024

Become a part of our caring community and help us put health first

Humana is seeking an experienced management professional to lead the Pharmacy Stars team. In this role, the selected candidate will be responsible for the strategy, opportunity evaluation, planning oversight, coordinating the development and monitoring outcomes.
This position will work and collaborate with leaders across the Humana enterprise, HPS executive leaders as well as have extensive engagement representing Humana with external partners.
This individual will leverage their deep pharmacy background and strong collaboration and communication skills to drive improvement in measures that impacts Stars performance, driving programs and process improvements to improve member health and well-being. This position requires an in-depth understanding of how Stars is impacted by multiple organization capabilities that interrelate across the function and Humana business overall.

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Responsibilities

  • Leads positive performance of medication adherence, statin use, polypharmacy, and Medicare Plan Finder measures for Pharmacy by influencing both the strategy and execution of improvement opportunities through collaboration with internal and external partners
  • Serves as primary liaison and representative between Pharmacy and Corporate Stars/Quality Teams, serving as Enterprise Part D/Pharmacy Stars Task Force Leader
  • Responsible party within Stars team for driving performance in Pharmacy related Star ratings along with collaborating on other measures including HEDIS and CAHPS
  • Defines multi-year Pharmacy Stars strategic plans and influences partners who directly execute member and provider touchpoints; identifies key details necessary to mitigate risks and ensure quality experiences
  • Develops strategies for various segments of member population (i.e., members chronically non-compliant, members New to Therapy, segmentation)
  • Gains approval for funding and manage budgets for programs


Use your skills to make an impact

Required Qualifications

  • Five years of leadership experience
  • Eight years clinical experience in managed care or equivalent experience
  • Registered pharmacist with license in good standing; Degree of Doctor of Pharmacy or equivalent
  • Deep business and financial acumen
  • Strong track record of driving solutions that achieved clinical and financial outcomes
  • Experience with effectively coaching, developing and leading direct reports and cross-functional teams
  • Complex and innovative problem-solving, analytical, critical and strategic thinking capabilities; knows how to create options and then converge on solutions
  • Brings an organized, attention-to-detail approach (strong tactical execution)
  • Exceptional cross-functional collaboration, relationship management, influencing, and interpersonal skills
  • Impeccable oral and written communication skills, as well as the polish, poise, and executive presence to effectively interact with and present to external partners and executive and senior-level stakeholders
  • Very disciplined; has the ability to manage competing priorities and operate effectively within a large and complex organizational structure
  • Ability to engage, educate, influence and guide matrixed teams at all levels on the concepts, opportunities and strategy of managing specialty and traditional medications

Preferred Qualifications

  • MBA, pharmacoeconomics or health outcomes training
  • Experience in finance and/or business related pharmacy practice
  • Previous experience with CMS Stars, specific to Pharmacy, Patient Safety, and Drug Pricing

Additional 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 Humana@myworkday.com with instructions on how to add the information into your official application on Humana’s secure website.
As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue 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

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.


$164,700 - $226,600 per year


This 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

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.