National Provider Accounts Lead

Profile

Description

The National Provider Accounts Lead role supports national providers in their Humana Medicare Advantage Prescription Drug (MAPD) plans for all pharmacy activities and works on problems of diverse scope and complexity ranging from moderate to substantial. National Provider Accounts Lead utilizes a broad understanding of managed care and PBM knowledge to develop, and/or implement strategies and programs to mitigate cost trend, optimize dispensing channels and improve health outcomes.

Responsibilities

The National Provider Accounts Lead (NAPL) role utilizes a broad range of deep Pharmacy expertise, experience and communication skills to support their assigned national accounts. The NAPL is aligned with, and an integral member of, Pharmacy Integration and Customer Success teams as well as Enterprise Teams and key external Provider Groups and deploys their skills in implementing strategies and programs to mitigate cost trend and improve health outcomes. The NAPL utilizes broad understanding of managed care and PBM knowledge to develop and support provider initiatives across all Pharmacy Growth channels.

This role supports Humana Medicare Advantage Prescription Drug (MAPD) plans for all national pharmacy activities. In this role you will:


Primary focus of position is the pharmacy subject matter expert, supporting external partners (value based providers systems), and internal partners (**MEMBERS ONLY**SIGN UP NOW***. Primary Care Organization, but not limited to MAPD lines of business).
Providing financial and utilization analysis to our external provider systems related to drug trend management.
Participating in internal **MEMBERS ONLY**SIGN UP NOW***. relevant operational meetings.
Supporting providers with Part B/Part D performance metrics to ensure success as they move along the Path to Value risk continuum.
Provide clinical support to provider systems through operational and executive meetings.
Creating a high level of engagement with the respective divisional leadership/provider groups and Provider Engagement team leadership.
Engaging the national providers with Humana Pharmacy Solutions (HPS) programs and leading the pull-through of HPS initiatives.
Identifying the new programs and industry best practices that could be considered as part of trends and best practices.
Work with internal stakeholders to define appropriate messaging, strategy and data analysis for external provider systems.
Provide expertise and support to external provider systems related to pharmacy quality and CMS STARS measures.


Required Qualifications


Bachelor's degree in Business or Pharmacy
Demonstrated managed care and/or PBM experience
5 or more years of sales experience or account management working with physicians/providers
Successful track record in facilitating and consulting across teams and managing projects
Thrives in a fast paced, multi-project work environment while still ensuring attention to detail
Excellent communication skills, both oral and written
Proficiency in Microsoft Word, Excel, & PowerPoint
Expertise in working collaboratively and communicating with staff in different positions and all levels of management positions
Ability to present to executive level individuals
Experience working with CMS guidelines and Medicare Advantage


Desired Qualifications


Master's in Business or PharmD
Experience with pharmacy benefits and health benefits
Knowledge of Humana's internal policies and procedures


Additional Information

Travel up to 20%

Must reside in EST or CST

You will report to the Director, Channel Development. This area is under the leadership of the VP of Pharmacy Growth Strategy.

Humana and its subsidiaries require vaccinated associates who work outside of their home to submit proof of vaccination, including COVID-19 boosters. Associates who remain unvaccinated must either undergo weekly negative COVID testing OR wear a mask at all times while in a Humana facility or while working in the field.

Scheduled Weekly Hours

40

Company info

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