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

The Senior Pharmacy Contracting Professional is responsible for reporting, implementation, and maintenance of Humana's Healthy Horizon Medicaid business. The Senior Pharmacy Contracting Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.

The Senior Pharmacy Contracting Professional ensures contract compliance and performs analysis regarding pharmacy claims and network composition to identify contracting needs to provide adequate coverage for Humana Health Horizons membership. The individual in this position will operate under Humana's Pharmacy Benefits Manager (PBM), Humana Pharmacy Solutions, to maintain Humana's pharmacy network for existing and upcoming Medicaid business. The primary responsibilities of the position include overseeing pharmacy network setups, day-to-day pharmacy network maintenance, and reporting (e.g., geo access, network directories, etc.) to internal business partners throughout the company to ensure compliance with state Medicaid requirements. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude in determining objectives and approaches to assignments.

Use your skills to make an impact
 

Required Qualifications

• Pharmacy Benefits Manager (PBM) experience
• Experience in pharmacy contracting, pricing, or adjudication including development, implementation, and maintenance.
• Expertise in utilizing Microsoft Excel to analyze, interpret, and report out on observed data
• Strong financial acumen with proficiency in analyzing and interpreting data
• Ability to manage multiple tasks and deadlines with attention to detail
• Able to give direction and make sound business decisions
• Must be passionate about contributing to an organization focused on continuously improving consumer experiences

Preferred Qualifications

• Bachelor's Degree
• Experience using Quest Analytics or similar software
• Familiarity with pharmacy contracting processes and contracting software (e.g., Icertis)
• Experience working with state Medicaid agencies
• Proficiency with Power BI
• Process improvement experience

Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

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.

 

$78,400 - $107,800 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.

Application Deadline: 09-18-2025

About us
 

About CenterWell Pharmacy: CenterWell Pharmacy provides convenient, safe, reliable pharmacy services and is committed to excellence and quality. Through our home delivery and over-the-counter fulfillment services, specialty, and retail pharmacy locations, we provide customers simple, integrated solutions every time. We care for patients with chronic and complex illnesses, as well as offer personalized clinical and educational services to improve health outcomes and drive superior medication adherence.

About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation’s largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability,