Senior Clinical Pharmacist

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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. This pharmacist will 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.

Key responsibilities include:

• 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.

Use your skills to make an impact

Required 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.

Preferred Qualifications

• 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

Workstyle: Remote work at Home

Location: U.S.

Schedule: Monday through Friday 8:00 AM - 5:00 PM Eastern Time

Travel: Possibly one time annually

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

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.

$126,300 - $173,700 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…