Senior Pharmacy Clinical Advisor
Humana

Job Info

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Description

The Senior Pharmacy Clinical Advisor serves as a business consultant for the Quality Network and Clinical & Quality Innovation programs supporting Patient Safety and Stars goals of combining clinical Rx acumen to achieve holistic health outcomes. This role will collaborate with key internal Pharmacy partners, Program Clinical Lead, and manage external vendor relationships. The Senior Pharmacy Clinical Advisor work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors to determine the best course of action.

Responsibilities

The Senior Pharmacy Clinical Advisor manages all aspects of a project, from start to finish, so it is completed on time and within budget. The advisor ensures that the efforts of multiple cross-functional project teams responsible for specific work streams are working in an integrated manner to optimize the experience and ensure timely completion of key milestones. The advisor must be proficient in all stages of project development including budget management, data management, and scope development and management. The advisor must have an in-depth understanding of business strategy, departments and segments organizational strategy and operating objectives, including their linkages to related areas. The advisor is responsible for leading, negotiating, drafting and executing vendor contracts. The advisor establishes vendor touch base meetings and quarterly business reviews. The advisor makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and received guidance where needed. The advisor will follow established guidelines/procedures.

Responsibilities:

• Partner with Program Clinical Lead to drive long term strategic planning through the project management methodologies (initiation, planning, execution, control, and closing)
• Maintain timelines, determine requirements and feasibility
• Understanding of the Quality Network Program - measures, mechanics, business stakeholders
• Identify market trends, gaps and opportunities to gain process, system, and member experience efficiencies
• Facilitate collaboration among stakeholders to define business requirements, resolve risks, define mutual goals, discuss reporting needs, strategic initiatives and improvements
• Create detailed project design and development documents and task-level project plans to organize cross-functional teams from strategy to implementation & launch
• Manages all aspects of vendor onboarding including creating & entering aSSIST case and completing due diligence reviews
• Develop, negotiate, and execute various contracts and schedules necessary for vendor work with Humana; work with Humana Enterprise Vendor Management Team
• Establish vendor operation meeting cadence, conduct meetings, prepare meeting minute reports to communicate the status of the program, review issues, establish Service Level Agreements (SLAs), implement change request(s) and any other items
• Ensure documented organizational project policies and procedures are followed; Identify areas of opportunity for and create new policy and procedures
• Assist with ROI analyses, program level budgets and program level reporting and metrics

Required Qualifications:

• Bachelor's degree or equivalent and minimum 5 years of technical healthcare experience
• Exceptional oral and written communications skills, including preparing and presenting information to executive-level audiences
• Proven ability to perform complex data analysis that are relevant to business needs
• Flexible, dynamic personality who works well in a team environment and can lead a project
• Excellent computer skills including Microsoft Word, Outlook, PowerPoint & Excel
  
  Preferred Qualifications:
  
  

• Master's Degree in Business, Finance, Healthcare Administration or related field
• Project Management experience (PMP a plus)
• Vendor Management experience
• Six Sigma or Green Belt
• Deep knowledge of Humana's operations and its mission, values, priorities, and culture

Scheduled Weekly Hours

40

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