Clinical Pharmacist Lead

3 weeks ago

Hartford, United States Humana Full time

Humana Clinical Pharmacist Lead - Hartford, Connecticut

Become a part of our caring community and help us put health first The Clinical Pharmacist Lead 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 Pharmacist Lead works on problems of diverse scope and complexity ranging from moderate to substantial. This includes analyzing complex pharmacy spend issues, identifying trends, forecasting utilization management effectiveness, and developing innovative cost-saving strategies. The ideal candidate will have a strong analytical background, excellent presentation skills, a keen interest in pharmacy economics, with experience in data analysis and financial modeling. They will translate clinical data into financial insights, present findings to executives, and collaborate with cross-functional teams to optimize cost management. The Clinical Pharmacist Lead within the Pharmacy and Medical Trend team plays a crucial role in analyzing and managing pharmacy spend to ensure cost-effective medication utilization for our members. The Clinical Pharmacist Lead will be responsible for forecasting utilization management effectiveness, identifying trends, analyzing complex problems related to pharmacy spend and developing innovative solutions for savings calculations. This role requires strong analytical skills, a deep understanding of pharmacy economics, and the ability to present findings to senior leadership effectively. This person exercises independent judgment requiring analysis of variable factors and determining the best course of action. Key Responsibilities: Analyze complex pharmacy spend problems, identify trends, and determine causes and effects. Forecast the effectiveness of utilization management in converting to preferred products or preventing inappropriate drug usage. Develop innovative methods for calculating savings and optimizing cost management strategies. Present analyses and findings to executives, anticipating questions and providing clear, concise explanations. Collaborate with clinical subject matter experts to translate clinical information into financial forecasts and communicate these insights to actuaries. Collaborate with cross-functional teams to develop and implement cost-saving initiatives. Stay current with industry trends and regulatory changes affecting pharmacy economics. Demonstrate curiosity and a proactive approach to understanding the economic impact of pharmacy trends. Use your skills to make an impact Required Qualifications: PharmD from an accredited institution. Active pharmacist license with the Board of Pharmacy in the state of residence. Proven experience in analyzing pharmacy spend and identifying trends. Strong skills in forecasting, data analysis, and financial modeling. Ability to develop innovative solutions for cost management and savings calculations. Excellent presentation skills, with experience presenting to executive-level audiences. Ability to think on your feet and anticipate potential questions or concerns. Strong interest in the economics of pharmacy and healthcare. Ability to translate clinical data into financial insights for forecasting purposes. Excellent communication and collaboration skills. Proficiency in relevant software and data analysis tools. Expertise in working collaboratively and communicating with staff in different positions and all levels of management positions. Preferred Qualifications: Managed Care Residency Training. Board Certification. Master's Degree in Business Administration or a related field. Experience with Medicare. Experience with pharmacy benefit manager utilization management practices.

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