Senior Clinical Pharmacist

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

📋 Description

• Deliver clinical and operational guidance for Medicaid Medication Therapy Management (MTM) programs across various state markets.

• Convert state clinical goals into efficient MTM program frameworks.

• Ensure the continuous administration of Medicaid MTM initiatives.

• Act as a clinical MTM subject-matter expert.

• Collaborate closely with state market partners, vendors, and other key stakeholders.

• Supervise program eligibility, clinical service design, reporting, budget management, and ongoing program effectiveness.

• Establish and uphold program eligibility and CMR/TMR service design.

• Manage processes related to program eligibility.

• Oversee vendor partnerships and program budgeting.

• Coordinate necessary monthly, quarterly, and annual state reporting.

• Keep abreast of changing Medicaid requirements.

• Provide Quality Program oversight for both Medicare and Medicaid MTM programs.

• Ensure that program design adheres to state-specific requirements, contractual obligations, RFP commitments, and clinical objectives.

• Report to an Associate Director.

⛳️ Requirements

• Current Pharmacist license with the Board of Pharmacy in the relevant state of residence.

• At least one (1) year of experience in a pharmacy environment.

• Proficient in MS Office Suite.

• Capable of navigating various systems and platforms.

• Able to troubleshoot general technical issues in a remote setting.

• Demonstrated experience managing multiple projects and prioritizing based on business needs.

• Availability to work Monday through Friday, 8:00 AM - 5:00 PM Eastern Time.

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

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

• PharmD is preferred.

• Experience in a Health Plan setting is preferred.

• Familiarity with Medicaid as it pertains to pharmacy is preferred.

• Six Sigma and/or Project Management Professional certification is preferred.

• Pharmacy practice residency or comparable pharmacy practice experience is preferred.

🏝️ Benefits

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

• Medical, dental, and vision benefits.

• 401(k) retirement savings plan.

• Paid time off.

• Company and personal holidays.

• Paid parental and caregiver leave.

• Short-term and long-term disability coverage.

• Life insurance.

• Personal wellness and smart healthcare decision support.

• Occasional travel to Humana offices for training or meetings may be required.