[Hiring] Senior Clinical Pharmacist @Humana

Role 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.

The Senior Clinical Pharmacist will report to an Associate Director and lead the clinical and operational administration of Medicaid MTM programs across multiple state markets. The pharmacist will ensure that program design aligns with state-specific requirements, contractual obligations, RFP commitments, and clinical goals.

• 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

Qualifications

• Must have an 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

Requirements

• 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

Benefits

• Medical, dental, and vision benefits
• 401(k) retirement savings plan
• Time off (including paid time off, company and personal holidays, paid parental and caregiver leave)
• Short-term and long-term disability
• Life insurance
• Many other opportunities

Company Description

Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it.