Associate Director – Formulary Operations Management

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

📋 Description

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

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

• Assist in utilization management initiatives, encompassing prior authorization, step therapy, quantity limits, and coverage.

• Analyze data and reporting to assess formulary performance and its operational impacts.

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

• Create and uphold policies, procedures, and documentation that support formulary operations.

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

• Spearhead strategic initiatives aimed at formulary optimization, operational excellence, and process enhancement.

• Direct, develop, and nurture a high-performing team through setting expectations, coaching, career growth, accountability, and engagement.

• Oversee formulary operations workflow, quality, capacity, training, reporting, issue resolution, and personnel leadership.

• Adhere to standard business hours in Eastern Time.

⛳️ Requirements

• Bachelor's degree OR a minimum of 6 years of experience in healthcare, pharmacy benefit management (PBM), managed care, health plans, formulary, pharmacy operations, or related fields.

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

• Proven experience in leading cross-functional initiatives that involve various stakeholders.

• Strong analytical and problem-solving capabilities.

• Exceptional organizational and project management skills.

• Capacity to handle multiple priorities and deadlines in a dynamic environment.

• Outstanding verbal and written communication skills, with proficiency in executive-level communication.

• Extensive knowledge of Microsoft Office applications, including Excel, PowerPoint, Word, and Teams.

• Proven ability to influence and drive organizational outcomes.

• A strong desire to contribute to an organization dedicated to continuously enhancing consumer experiences.

• Self-supplied internet service with a minimum download speed of 25 Mbps and upload speed of 10 Mbps.

• A dedicated workspace free from interruptions to safeguard member PHI/HIPAA information.

🏝️ Benefits

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

• Medical insurance benefits.

• Dental insurance benefits.

• Vision insurance benefits.

• 401(k) retirement savings plan.

• Paid time off.

• Company holidays.

• Personal holidays.

• Paid parental leave.

• Paid caregiver leave.

• Short-term disability coverage.

• Long-term disability coverage.

• Life insurance coverage.

• Option for remote work.

• Occasional travel to Humana offices for training or meetings.