HPS Clinical Drug Policy Management - Senior Operations Professional

Profile

Description

The Senior Clinical Drug Policy Management Professional provides clinical and operational leadership for the creation and maintenance of clinical tools which help facilitate clinical medication review decision. The Senior Clinical Drug Policy Management Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.

Responsibilities

Provides operational leadership for the creation and maintenance of clinical tools which help facilitate clinical medication review decision making

Work responsibilities are varied and frequently require interpretation and independent determination of the appropriate courses of action

Ensures accuracy of clinical tools builds across multiple systems (PA Hub, CPS, IRx) by assisting the expansion of quality programs within the Medicaid space

Collaborates with healthcare professionals, pharmacists, and other business functions to operationalize processes

Performs analysis and reporting to ensure optimal operational flow

Develops key performance indicators and plans to improve overall Medicaid processes and efficiency

Creates Clinical Drug Policy Management process and training documentation

Provides excellent service to our customers and stakeholders

Begins to influence department's strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude in determining objectives and approaches to assignments.

Required Qualifications

Bachelor's degree

2 - 5 years of experience of leading successful continuous improvements projects using various process tools like Value Stream Mapping (VSM), Pareto analysis, fish bone diagrams etc.

Comprehensive experience in analysis with the ability to graphically represent data

Experience in change management techniques and project implementation

Extensive knowledge of process re-engineering techniques

Comprehensive knowledge of all Microsoft Office applications, including Excel, Word, PowerPoint, Project and Visio

Preferred Qualifications

Strong consultative skills and relationship building skills

Must be passionate about contributing to an organization focused on continuously improving consumer experiences

Lean Certification, Six Sigma Black Belt or higher designation

Additional Information

Scheduled Weekly Hours

40

Company info

Humana Inc.
Website : http://www.humana.com