Medical Cost Management - Pharmacy Advisor

Profile

Job Information

Humana

Medical Cost Management - Pharmacy Advisor

in

Boston

Massachusetts

Description

The Medical Cost Management - Pharmacy Advisor provides support to assigned health plan and/or specialty companies relative to Medicare/Medicaid/TRICARE product implementation, operations, contract compliance, and federal contract application submissions. The Market Development Advisor works on problems of diverse scope and complexity ranging from moderate to substantial.

Responsibilities

Driving medical cost management initiatives and digging into trends is complicated and requires collaboration across the enterprise to make progress. The Medical Cost Management Team is looking for a Medical Cost Management - Pharmacy Advisor to drive progress over perfection towards achievement of Employer Group's #1 goal, Cost of Care. As the Directly Responsible Individual, you'll lead investigation efforts of cost of care initiatives. These highly visible initiatives require someone who can see the big picture and take the steps necessary to create and present business cases with compelling recommendations on how to proceed. Success in this role looks like:

Achievement of our 2022 Trend Bender Goal of $225M

Influential leader of cross functional teams

Collaborative, curious and data driven.

Process steward, help gain enterprise wide adoption of the new trend governance process.

Passionate learner and navigates ambiguity from a place of curiosity and respect

Leverage outside-in thinking to keep a pulse on new opportunities to fill the trend pipeline.

Required Qualifications

Employer Group Trend, Clinical Trend, or Retail Trend Experience

Critical Thinking and Problem Solving Skills

Success in developing and managing working relationships within a highly matrixed business environment

Enjoys working in a collaborative team environment

Ability to perform and excel in fast paced and ever evolving environment

Strong written and verbal communication skills

Strong presentation skills to various levels of leadership

BS in business or 5 years equivalent experience

Willing to travel based on business need.

Must have the ability to provide a high-speed DSL or cable modem for a home office (Satellite and Wireless Internet service is NOT allowed for this role). A minimum standard speed of 10x1 (10mbs download x 1mbs upload) is required

We will require full COVID vaccination (https://www.cdc.gov/coronavirus/2019-ncov/vaccines/fully-vaccinated.html#vaccinated) for this job as we are a healthcare company committed to putting health and safety first for our members, patients, associates and the communities we serve. If progressed to offer, you will be required to provide proof of full vaccination or documentation for a medical or religious exemption consideration where allowed by law.

Preferred Qualifications

MBA in business or equivalent experience

Previous EG Trend Initiative experience/continuous improvement driven work

Project/Program management experience

Additional Information

As part of our hiring process, we will be using an exciting interviewing technology provided by Modern Hire, a third-party vendor. This technology provides our team of recruiters and hiring managers an enhanced method for decision-making.

If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes.

If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone or computer to answer the questions provided. Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.

Scheduled Weekly Hours

40

Company info

Humana Inc.
Website : http://www.humana.com