Associate Director – Formulary Operations Management

This is a fully remote position, open to applicants in United States.

📋 Description

• Lead the development and maintenance of formularies across relevant products and business lines.

• Oversee the operational execution of formulary modifications in collaboration with clinical, configuration, product, and operational teams.

• Assist in the creation and implementation of utilization management programs, which include prior authorization, step therapy, quantity limits, and coverage.

• Assess formulary performance and operational effects through data analysis and reporting.

• Ensure adherence to state, federal, and client formulary regulations.

• Create and sustain policies, procedures, and supporting documentation for formulary operations.

• Collaborate with stakeholders on formulary submissions, audits, regulatory reviews, and implementations.

• Drive strategic initiatives related to formulary enhancement, operational excellence, and process improvement.

• Lead, develop, and nurture a high-performing team through expectation-setting, coaching, career growth, and accountability.

• Manage the workflow, quality, capacity, training, reporting, issue resolution, and personnel leadership related to formulary operations.

• Operate during regular Eastern Time business hours.

⛳️ Requirements

• A Bachelor's degree.

• A minimum of 6 years of experience in healthcare, pharmacy benefit management (PBM), managed care, health plans, formulary, pharmacy operations, or a related field.

• At least 2 years of experience in leadership, management, project leadership, or people management roles.

• Proven experience in leading cross-functional projects involving multiple stakeholders.

• Strong analytical and problem-solving capabilities.

• Excellent organizational and project management skills.

• Capacity to manage multiple priorities and deadlines within a fast-paced environment.

• Outstanding verbal and written communication skills, including the ability to communicate at the executive level.

• In-depth knowledge of Microsoft Office applications, including Excel, PowerPoint, Word, and Teams.

• Proven ability to influence and drive organizational results.

• Strong problem-solving, critical thinking, and analytical abilities.

• A passion for contributing to an organization focused on continually enhancing consumer experiences.

• Reliable home internet connection with a minimum download speed of 25 Mbps and upload speed of 10 Mbps.

• Ability to work from a dedicated location without interruptions to safeguard member PHI/HIPAA information.

🏝️ Benefits

• Bonus incentive plan based on company and/or individual performance.

• Medical benefits.

• Dental benefits.

• Vision benefits.

• 401(k) retirement savings plan.

• Paid time off.

• Company holidays.

• Personal holidays.

• Paid parental leave.

• Paid caregiver leave.

• Short-term disability.

• Long-term disability.

• Life insurance.

• Dedicated work-from-home space.

• Remote work arrangement.

• Occasional travel to Humana offices for training or meetings.