Formulary Operations Management Professional 2

Profile

Description

The Formulary Operations Management Professional 2 provides clinical and operational support for build, maintenance, submission, and management of formularies and drug lists. Work responsibilities are varied and frequently require interpretation and independent determination of the appropriate courses of action. Ensures accuracy of formularies and utilization management (UM) criteria in the Formulary Enterprise and claims processing systems. Collaborates with healthcare professionals, pharmacists, and other business functions to operationalize formularies. Performs formulary analysis and reporting to ensure optimal operational flow. Develops key performance indicators and plans to improve overall processes and efficiency. Creates and maintains formulary management process and training documentation.

Provides excellent service to our customers and stakeholders. This individual will support Humana's Commercial and Medicaid lines of business.

Responsibilities

Key Competencies:

Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas

Understands Humana's business processes, systems, tools, regulations and structure

Demonstrates appropriate knowledge of company customers and/or business partners and their needs and requirements

Makes decisions regarding own work methods, occasionally in ambiguous situations

Follows established guidelines/procedures

Develops and optimizes end-to-end processes

Motivates and inspires teammates to increase engagement, productivity and personal achievement

Actively listens and ensures understanding regardless of the communication vehicle

Effectively leverages available resources (financial, people, time) to accomplish objectives

Required Qualifications

Bachelor's degree or 3 years equivalent experience in technical skill application

Strong consultative skills and relationship building skills

Prior demonstrated experience with process improvement or process design and implementation roles

Excellent data analysis and experience working with Microsoft Office applications, including Excel, Access, Word, Project and Visio

Ability to work on multiple projects

Ability to successfully handle change in a fast paced environment

Preferred Qualifications

Lean, Green Belt experience and/or certifications

Previous experience with pharmacy and/or benefits management

Previous Commercial, Medicare and/or Medicaid experience

Excellent written and verbal communication skills

Excellent planning and organizational skills

Scheduled Weekly Hours

40

Company info

Humana Inc.
Website : http://www.humana.com