Description
The Senior Clinical Pharmacist provides clinical and operational leadership for Medicaid Medication Therapy Management (MTM) programs across multiple state markets.
This role is responsible for translating state clinical objectives into effective MTM program designs and ensuring ongoing administration of those programs.
The position serves as a clinical MTM subject-matter expert and works closely with state market partners, vendors, and other stakeholders to oversee program eligibility, clinical service design, reporting, budget management, and ongoing program performance.
Responsibilities:
- Establishing and maintaining program eligibility and CMR/TMR service design
- Overseeing program eligibility processes
- Managing vendor relationships and program budgets, coordinating required monthly, quarterly, and annual state reporting
- Monitoring evolving Medicaid requirements, including Quality Program oversight for Medicare and Medicaid MTM programs
Requirements:
- Active Pharmacist license with the Board of Pharmacy in the appropriate state of residence
- Minimum one (1) year of experience in a Pharmacy setting
- Proficiency with MS Office Suite and navigation through multiple systems and platforms, troubleshooting general technical difficulties in a remote environment
- Professional experience managing multiple projects and prioritizing as business needs change
Preferred Qualifications:
- PharmD
- Health Plan experience
- Knowledge of Medicaid as it relates to pharmacy
- Six Sigma and/or Project Management Professional certification
- Pharmacy practice residency or similar pharmacy practice experience
Workstyle: Remote work at Home
Location: U.S.
Schedule: Monday through Friday 8:00 AM - 5:00 PM Eastern Time
Travel: Possibly one time annually
Benefits: Humana offers competitive benefits that support whole-person well-being, including medical, dental and vision benefits, 401(k) retirement savings plan, time off, short-term and long-term disability, life insurance, and many other opportunities.
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