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

The Rx Clinical Programs Pharmacist Lead develops and integrates programs developed to improve overall health outcomes with a focus on prescription drugs. The Rx Clinical Programs Pharmacist Lead works on problems of diverse scope and complexity ranging from moderate to substantial.

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 Clinical Pharmacy Lead is a key stakeholder to Pharmacy and Medicare Retail organization leadership in the management of Value Based Providers. Clinical Pharmacy Leads (CPLs) have a key focus on provider engagement with value based primary care practices in improving financial, clinical, and quality outcomes related to pharmacy Key Performance Indicators. CPLs manage the entire Value Based (VB) Provider Panel within their respective regional alignment as their book of business. They use data points around current performance (mail order rate, patient safety scores, etc.) and input from Retail stakeholders to prioritize their engagements.

The Clinical Programs Pharmacist Lead works with our Value Based Provider Groups to collaborate with improved performance in STARS Patient Safety Measures, Part D Utilization Metrics such as GDR/PMPM and promotes mail order growth with owned assets. This role is a consultant and advisor to our value-based provider partners and internal teams. The RX Clinical Programs Lead delivers reporting and education on pharmacy topics such as formulary education, utilization tracking and trending, STARS performance and Mail Order % to providers. This pharmacist makes customized recommendations to provider groups on how they can meet clinical, quality, and financial goals. This position helps drive Part D STARS measures and medication adherence. Proactively drives health awareness with patients through Rx Education and targeted quarterly campaigns. 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.

Use your skills to make an impact

Required Qualifications
Must have an active Pharmacist license with the Board of Pharmacy in the appropriate state

Role Essentials:

• Bachelor's or other advanced pharmacy degree
• Active Pharmacist license in the state of Florida
• 5+ years’ experience as a practicing pharmacist
• Excellent organization and communication (verbal and written) skills
• Ability to work in a team environment and support common goals
• Must be able to travel to physician offices in South FL, Orlando & Miami
• Strong attention to detail; able to concentrate without distraction in a fast-paced environment
• Ability to prioritize multiple tasks, anticipate and solve problems
• Intermediate level or higher competency with MS Office programs such as Word, Excel and Power Point
• Ability to use digital platforms like Zoom, MS Teams or WebEx
• History of demonstrated business development capabilities
• Proficient in quality improvement processes, analyzing and interpreting financial trends
• Excellent written and verbal communication skills; effectively facilitates and present to large groups and all levels of leadership including HPS Exec/Humana Management Team level
• Ability to maintain high engagement level

Role Desirables:

• Medicare product experience
• Previous Provider Engagement experience
• Experience with development, monitoring and evaluating the KPIs and outcomes of pilots, test and learns and initiatives
• Familiarity with electronic medical record (EMR) systems
• Identify and implement innovative solutions for improved efficiencies and outcomes
• Multilingual (preferably English/Spanish)
• Experience in building strategy and quantifying outcomes of key organizational activities

Additional 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.

$112,400 - $154,900 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

About CarePlus Health Plans: CarePlus Health Plans is a recognized leader in healthcare delivery that has been offering Medicare Advantage health plans in Florida over 23 years. CarePlus strives to help people with Medicare, or both Medicare and Medicaid, achieve their best possible health and wellness through plans with benefits and services they care about. As a wholly owned subsidiary of Humana, CarePlus currently serves Medicare beneficiaries throughout 21 Florida counties.About Humana: Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers, and our company. Through our Humana insurance services, and our 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.