Humana · 1 day ago
Senior Pharmacy Contracting Professional
United States
Full-time
Remote
Mid, Senior Level
$78K/yr - $108K/yr
3+ years expHumana is a company committed to putting health first, and they are seeking a Senior Pharmacy Contracting Professional. This role involves understanding pharmacy network business processes, ensuring compliance with Medicare and Medicaid regulations, and serving as a point-of-contact for audits and issue resolution.
Health CareHealth InsuranceInsuranceVenture Capital
Responsibilities
Understand the impacts of new federal or state guidance and/or legislation on the pharmacy network and contracts
Corrective action/plan development: partner with business stakeholders to implement corrective actions and process improvements
Understand the pharmacy networks, their purpose, and impacts on other business processes and areas
Demonstrate a comprehensive understanding of the relationship between business needs and appropriate solutions
Close process gaps identified by Compliance
Use inquisitive, forward-looking, big picture thinking to improve processes and business outcomes
Influence others to gain support for initiatives or changes that will close gaps and/or improve business outcomes
Establish solid relationships with business groups in order to influence and understand on-going business needs
Qualification
Required
Bachelor's Degree
3 or more years experience in pharmaceutical industry or compliance related role
Strong business acumen with proficiency in analyzing and interpreting legislation, regulation, and contracts
Ability to manage multiple tasks and deadlines with attention to detail
Ability to communicate effectively and deliver presentations to senior management
Able to give direction and make sound business decisions
Must be passionate about contributing to an organization focused on continuously improving consumer experiences
Preferred
Process improvement experience
Benefits
Medical, dental and vision benefits
401(k) retirement savings plan
Time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave)
Short-term and long-term disability
Life insurance
Company
Humana
Humana is a health insurance provider for individuals, families, and businesses.
10001+ employees
Funding
Current Stage
Public CompanyTotal Funding
$13.07B2025-05-30Post Ipo Debt· $5B
2025-03-03Post Ipo Debt· $1.25B
2024-03-11Post Ipo Debt· $2.25B
Leadership Team
Jim Rechtin
CEO and President
Caleb Gallifant
Vice President Of Product
Recent News
2026-01-16
2026-01-16
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