Senior Clinical Pharmacist - Trend Detection

 Posted 20 hours ago
     
 $126K - $173K per year
  
5-10 years experience
Apply Now

Please mention DailyRemote when applying

AI Summary

The role focuses on identifying and investigating drug utilization and cost trends to inform financial forecasts and profitability for Medicaid plans. Responsibilities include conducting spend analysis, monitoring pharmaceutical sector developments, and contributing to formulary strategies to mitigate costs.

Become a part of our caring community
 

Be a part of an interactive team with broad exposure and scope within Humana. Humana is seeking a positive and proactive individual to contribute to a high performing team that helps translate the clinical into financial to ensure Humana profitability.
This individual will support our Clinical Trend Solutions team, working directly with financial analysts and clinical pharmacy leads as we inform Humana on the impact of emerging drug trends. This individual will focus on identifying and investigating the drug utilization and cost trends most likely to have impact on Humana's Medicaid plans

Responsibilities

  • Contributes to Humana’s pharmacy trend detection process by conducting analysis of drug spend, utilization, and/or approval scenarios
  • Researches and analyzes drugs and emerging therapeutics, including financial forecasts on the web and works with analysts to inform an internal financial forecast for the company
  • Continuously monitors relevant publicly available news/developments in the pharmaceutical sector, performing any ad hoc analyses and generating insights
  • Contribute to corporate communications of high quality to be shared with senior leadership such as trend analysis and market event notifications
  • Partners with pharmacists, data scientists, financial analysts in a team environment
  • Contributes to developing Humana formulary strategy to mitigate cost trend and improve health outcomes.
  • Contributes to the creation of trend communications to be shared at varying levels within the company, such as, presentations, emails, and executive summaries.

Competencies

  • Self-directed
  • Accountable to financial goals
  • Strong clinical research skills
  • Strong critical thinking skills
  • Demonstrates initiative and the ability to multi-task and prioritize assignments
  • Able to produce clear, concise process documentation
  • Excellent verbal and written communication skills
  • Strong organizational skills
  • Positive and proactive
  • Ability to assimilate, analyze, draw conclusions, and make recommendations from complex data
  • Flexible, dynamic personality who works well in a team environment and is also an individual contributor
  • Working knowledge of MS excel, MS PowerPoint required


Use your skills to make an impact
 

Required Qualifications

  • Bachelor's degree
  • Must have an active Pharmacist license with the Board of Pharmacy in the appropriate state
  • Must be passionate about contributing to an organization focused on continuously improving consumer experiences

Preferred Qualifications

  • PharmD
  • Health Plan experience
  • Knowledge of Medicare/Medicaid as it relates to pharmacy
  • Six Sigma and/or Project Management Professional certification
  • Pharmacy practice residency or similar pharmacy practice experience
  • Board Certified Pharmacotherapy Specialist (BCPS)
  • MBA, pharmacoeconomics or health outcomes training
  • Previous experience in trend analysis
  • Three years’ experience in pharmacy benefits management and Medicare/Medicaid
  • Understands managed care and is capable of generating insights into the business

Additional Information:

As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.

Work at home requirements:

To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:
At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested.
Satellite, cellular and microwave connection can be used only if approved by leadership.
Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.
Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

SSN Alert:

Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from Humana@myworkday.com with instructions on how to add the information into your official application on Humana’s secure website.

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.


 

$126,300 - $173,700 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: 06-22-2026


About us
 

About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at Humana.com and at CenterWell.com.


Equal Opportunity Employer

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

Similar Jobs

See all Remote Healthcare jobs →

Personalize your Remote Job Search in 3 Easy Steps!

Discover remote opportunities in Healthcare

Answer easy questions

Answer easy questions

200,000+ jobs across 15+ categories

Get your best job matches

Get your best job matches

Only hand-screened, legit jobs

Find a remote job faster

Find a remote job faster

No ads, scams, or junk

I was the first applicant for a remote marketing position that got listed on the company website the same day I applied. Had an interview within 48 hours!

Sarah J. — Sarah J. · Marketing Manager ★★★★★ Verified