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Humana Clinical Trend and Pharmacy Lead in Billings, Montana

Description

Responsibilities

The Clinical Strategy and Practice Lead builds strategies for development, engagement, best clinical practices and processes for clinical community within the enterprise. The Clinical Strategy and Practice Lead works on problems of diverse scope and complexity ranging from moderate to substantial.

Responsibilities

The Clinical Strategy and Practice Lead Advises executives to develop functional strategies (often segment specific) on matters of significance. Exercises independent judgment and decision making on complex issues regarding job duties and related tasks, and works under minimal supervision, uses independent judgment requiring analysis of variable factors and determining the best course of action.

Healthcare is rapidly changing, and our members are living longer, often with more chronic conditions. Consumers expect more personalized and holistic experiences from their health partners. Humana's Enterprise Clinical Operating Model (ECOM), is a multi-year strategy with the goal of improving member experiences and health outcomes through better integrating Humana's processes, technology and clinical capabilities. The leader occupying this role will be instrumental in executing on the vision of ECOM in partnership with leaders and teams across Humana.

Snapshot of position:

  • Responsible for oncology focused enterprise wide initiatives that aim to positively impact trend; improving the member experience, and enhancing health outcomes

  • Frequently working with clinical data & industry insights to improve member outcomes

  • Support Health Care Services stakeholders to fast-track opportunities that impact cancer strategies and other high cost conditions as directed

  • Experienced and well informed around the oncology episode of care; diagnosis, active treatment, post treatment levers

  • Serve as a Clinical Analytics and Trend SME helping to reduce cost and improve quality throughout all facets of the oncology member journey.

  • Can see the bigger picture and finds solutions to barriers that impede the delivery of initiatives that will improve outcomes

  • Attentiveness to the current regulatory environment while leveraging industry research that enhances our decision making.

  • Bias towards solving for clinical challenges particularly as they relate to optimizing the clinical capabilities to improve cost and reduce trend

  • Support leadership team around other specialty disease trend opportunities as needed

  • Work with various leaders and stakeholders in a matrixed environment to deliver outcomes.

  • Lean into ambiguity; ask probing questions to make informed decisions

  • Exhibit high character, honesty, and strong emotional intelligence

  • Facilitate and lead meetings internally and externally to advance initiatives

  • Collaborate with associates in Clinical Strategy and the Clinical Product Organization to deliver solutions that improve health outcomes, and patient experience

Essentials

  • 6-8 years working in healthcare or a related industry

  • Board Certified Oncology Pharmacist (BCOP)

  • Degree of Doctor of Pharmacy (PharmD or RPh) from an accredited School

  • Active, unrestricted pharmacy licensure

  • 3+ years in a role working directly with data and analytics

  • Strong business acumen and communication skills

  • Clinical training; licensed nurse or pharmacist, with experience in trend analysis

  • Strong presentation skills, developing concepts and communicating ideas

Desirables

  • MBA or Advanced degree

  • Healthcare market, payer, or provider business experience

  • Advanced Excel and manipulating large data tables

  • Active, unrestricted pharmacy licensure

Additional Information

Work at Home Nationwide

15-20% travel to Louisville when permitted

Scheduled Weekly Hours

40

Scheduled Weekly Hours

40

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