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