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The Clinical Drug Evaluation and Policy Strategies Senior Clinical Pharmacist monitors drug development pipeline, and medical literature, while providing clinical support for internal stakeholders. 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 Formulary Strategy Pharmacist work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.

The Clinical Drug Evaluation and Policy Strategies Senior Clinical Pharmacist develops, maintains, and/or operationalizes strategies related to utilization management edits and/or clinical coverage policies for pharmacy and medically administered drug products. This individual influences the department’s strategy.

• Participate in Humana’s formulary and Pharmacy and Therapeutics processes.

• Acts Strategically: Has vision, anticipates future consequences and trends accurately; has broad knowledge and perspective; creates competitive and breakthrough strategies and plans.

• Builds Trust: You honor your word by doing what you say you are going to do.

• Drives for Excellence: You are a continuous learner who encourages others to learn. By constantly upgrading your own work, you achieve results and outperform the competition.

• Innovates - Introduces or develops new ideas and processes which improve performance or productivity.

• Implementation/Execution: You are good at organizing and managing multiple priorities and/or projects by using appropriate methodologies and tools.

• Problem Solving: You are a problem solver with the ability to encourage others in collaborative problem solving. Acting as both a broker and consultant regarding resources, you engage others in problem solving without taking over.

Required Qualification:

• Pharmacy degree from an accredited school of pharmacy.

• Must have an active Pharmacist license with the Board of Pharmacy in the appropriate state.

• Complete clinical reviews, policy development, operations related to policy work, and recommend drug coverage and potential drug utilization tools to mitigate Humana’s cost and trend while improving our member’s health and costs.

• Serve as a clinical subject matter expert and provide clinical support across Humana.

• Conducts analysis on drug utilization trends to evaluate and inform formulary strategies.

• Collaborates on research projects and develops proposals for research projects.

• Develops corporate communications to be shared with senior leadership.

• Supports trend management by conducting analysis of drug spend, utilization, and/or ) approval scenarios.

• 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.

• Must be passionate about contributing to an organization focused on continuously improving consumer experiences.

• Clinical experience in managed care or other pharmacy related field.

• Less than 10% travel requirement including visit(s) to home office in Louisville, KY.

• BPS Board Certification (any BPS certification; BCOP Preferred).

Use your skills to make an impact
 

Preferred Qualifications

• Pharmacoeconomics and Health Outcomes training

• Pharmacy practice residency or similar pharmacy practice experience

• Knowledge of Medicare as it relates to pharmacy

• Six Sigma and/or Project Management Professional certification

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: 06-18-2026

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.

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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.