Clinical Pharmacist Lead, Fully Integrated Dual Eligible Special Needs Plan (FIDE-SNP) Michigan Medicare - Medicaid Health Plan

Remote, USA Full-time
**Overview:** We are seeking a seasoned Clinical Pharmacist Lead to join our team and lead the pharmacy program development for our Fully Integrated Dual Eligible Special Needs Plan (FIDE-SNP) Michigan Medicare - Medicaid health plan. As a Clinical Pharmacist Lead, you will leverage your broad understanding of managed care and pharmacy benefit management (PBM) to develop and implement strategies and programs that mitigate cost trends and improve health outcomes. **Responsibilities:** • Keep current with State and Federal regulations regarding the practice of Pharmacy and implement changes as necessary to maintain compliance supporting both the business and public relations strategies. * Develop corporate communications to be shared with senior leadership. * Support trend management by conducting analysis of drug spend, utilization, and/or approval scenarios. * Advise executives to develop functional strategies (often segment specific) on matters of significance. * Exercise independent judgment and decision making on complex issues regarding job duties and related tasks. * Work under minimal supervision, using independent judgment requiring analysis of variable factors and determining the best course of action. * Facilitate and consult across teams and managing projects working collaboratively and communicating with staff in different positions and all levels of management positions. * Manage the Humana Michigan FIDE-SNP health plan relationship with our internal PBM, Humana Pharmacy Solutions ensuring compliance with programmatic requirements, such as claims processing, prior authorization, formulary management and clinical programming. * Represent Humana at all Pharmacy Medicaid meetings including those with the Michigan Department of Health and Human Services (MDHHS). **Qualifications:** • Bachelor's degree in Pharmacy or Doctor of Pharmacy (PharmD) • Must have an active Pharmacist license with the Board of Pharmacy in the appropriate state AND have a Michigan license or ability to obtain • Minimum of ten plus years of Pharmacy Experience with at least three years' experience in managed care and/or PBM operations • Ability to travel 10% of time • Successful track record in facilitating and consulting across teams and managing projects • Thrives in a fast-paced, multi-project work environment while still ensuring attention to detail • Excellent communication skills, both oral and written • Proficiency in Microsoft Word, Excel, & PowerPoint • Expertise in working collaboratively and communicating with staff in different positions and all levels of management positions • *Benefits:** • Competitive salary range: $138,900 - $191,000 per year • Bonus incentive plan • Comprehensive 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 Apply tot his job
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