Clinical Advisor, Pharmacy Trend Management – Louisville

Humana Inc., headquartered in Louisville, Kentucky, is one of the nation's largest publicly traded health benefits companies, with approximately 11 million medical members located primarily in 15 states and Puerto Rico. Humana offers a diversified portfolio of health insurance products and related services - through traditional and consumer-choice plans - to employer groups, government-sponsored plans, and individuals.

Over its 43-year history, Humana has consistently seized opportunities to meet changing customer needs.

Today, Humana is a leader in consumer engagement. Throughout its diversified customer portfolio, the company provides guidance that can both help lower costs and lead to a better health plan experience.


Role: Clinical Advisor, Pharmacy Account Management
Location: Louisville, KY

Assignment Capsule
This role will have important leadership opportunities within the company and how we manage the delivery of the pharmacy benefit.

• Supporting the development of relationships with the Humana Market Medical Directors to liaison on strategies around controlling pharmacy drug spend and trend
  
• Responsible for understanding the PBM competitive marketplace and supporting the RFP / Sales process with that information.
  
• Supporting the development of strategies to grow pharmacy sales within our Commercial Segments
  
• Supporting the interface with and influencing of the Pricing Trend in the underwriting process (this is done through relationships within pharmacy and driving those relationships into the actuarial, underwriting and financial processes)
  
• Supporting the request for proposal process for Commercial business with the Corporate Proposal Center and Pharmacy Staff
  
• Supporting the identification of new programs and industry best practices that should be considered as part of core programming
  
• Participating in Commercial Group sales opportunities as assigned
  
• Participating in periodic pharmacy benefit reviews for existing customers

Role Essentials

• Experience with analytics / metrics and financial analysis of Pharmacy data
  
• Pharmacist degree preferred. B.S. or master's degree in Healthcare field would be considered, MBA desirable.
  
• 2 years clinical experience in managed care
  
• Experience with spreadsheets / analytics
  
• Excellent communication and presentation skills
  
• Excellent relationship building and networking skills
  
• Previous PBM / Managed care / Pharmacy Consultant/ Account Management experience a plus.

Reporting Relationships
This role reports directly to the Director, Pharmacy Sales and Segment Support and has the following responsibilities:

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