Pharmacy Stars Improvement Lead

Pharmacy Stars Improvement Lead

Become a part of our caring community

The Pharmacy Stars Improvement Lead will be a part of a collaborative Pharmacy Stars team which is accountable for Humana's Stars patient safety measure performance. The Pharmacy Stars Improvement Lead will autonomously develop, implement, and manage clinical program strategies to improve Medicare members' medication adherence and appropriate medication use with specific focus on telehealth and in-home methods of care delivery. The Pharmacy Stars Improvement Lead exercises independent judgment and decision making on complex issues regarding job duties and related tasks, works under minimal supervision, and analyzes variable factors to determine the best course of action.

Use your skills to make an impact

Required Qualifications

• Bachelor's Degree in Business, Finance, Health Care or a related field
• 2 or more years of project leadership experience
• Prior Medicare/Medicaid experience
• Strategic thinking and planning capabilities; organized and detail-oriented
• Excellent communication skills
• Enthusiasm and motivation essential; a confident change-agent; strong presentation skills (oral and written)
• Ability to operate under tight deadlines
• Comprehensive knowledge of all Microsoft Office applications, including Word, Excel and Power Point
• Must be passionate about contributing to an organization focused on continuously improving consumer experiences

Preferred Qualifications

• Medication prescribing and medical coding experience as PA, NP, or BSN preferred
• Master's Degree in Business Administration, Health Administration or a related field
• Progressive experience in the health solutions industry
• Provider relations experience
• Prior managed care experience
• Understanding of metrics, trends and the ability to analyze and identify gaps in care
• Proven organizational and prioritization skills and ability to collaborate with multiple departments a plus
• Understanding of CMS Stars, performance measures, HEDIS knowledge and experience a plus
• Background working in quality improvements

Additional Information

As part of our hiring process for this opportunity, we will be using an interviewing technology called Hire Vue to enhance our hiring and decision-making ability. Hire Vue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.

Work at home requirements:

To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:

At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested.

Satellite, cellular and microwave connection can be used only if approved by leadership.

Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.

Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.

Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

SSN Alert:

Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from  with instructions on how to add the information into your official application on Humana's secure website

Work at Home Requirements:
To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:
At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Travel:
While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Scheduled Weekly Hours 40

Pay Range $104,000 - $143,000 per year

This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including…