DescriptionThe Formulary Operations Management Professional 2 provides clinical and operational leadership for build, maintenance, submission, and updating of formularies and drug lists. The Formulary Operations Management Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.ResponsibilitiesThe Formulary Operations Management Professional 2 ensures accuracy of formularies and utilization management (UM) criteria in the Formulary Enterprise System. 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 formulary management process and training documentation. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures.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 QualificationsBachelor'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 QualificationsLean, 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
Work-At-Home RequirementsWAH requirements: Must have the ability to provide a high speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense.
A minimum standard speed for optimal performance of 25x10 (25mpbs download x 10mpbs upload) is required.
Satellite and Wireless Internet service is NOT allowed for this role.
A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information
Vaccination Info:Humana and its subsidiaries require vaccinated associates who work outside of their home to submit proof of vaccination, including COVID-19 boosters. Associates who remain unvaccinated must either undergo weekly negative COVID testing OR wear a mask at all times while in a Humana facility or while working in the field.Scheduled Weekly Hours40Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our https://www.humana.com/legal/accessibility-resources?source=HumanaWebsite.