- Humana • Metairie, LA 70001
Job #2041112640
- Description
The Medicaid Senior Market Development Professional will serve as the Pharmacy business SME
for the Medicaid line of business. This role will be responsible for the implementation of required deliverables prior to award, Medicaid day to day operations, issue resolution and process improvements, RFP responses, and will also serve as the PBM Liaison, as needed. This role will work in conjunction with pharmacists and operational partners as well as market contacts.
Responsibilities
This role consists of, but is not limited to, the following responsibilities:
- Assist with RFP responses
- Assist in developing and maintaining the Medicaid Pharmacy RFP library
- Work with Medicaid Leadership to define client deliverables and expectations
- Establish relationships with all HPS Operational areas for collaboration regarding client deliverables
- Ensure documentation tracking for all issues, action items, deliverables, decisions, etc.
- Responsible for facilitating calls/meetings/discussions for action plan development
- Monitor and drive action plan to resolution
- Proactive identification of potential client issues of concern
- Responsible for day to day operational oversight
- Report escalated issues to Leadership for awareness
- Manage all pre-implementation deliverables
- Serve as PBM Medicare Business Owner and Liaison
Required Qualifications
- Bachelor’s Degree in Business, Finance or a related field
- 5 years of professional work experience
- 3+ years of Pharmacy or PBM experience
- 3+ years of project management experience
- Previous Medicaid experience
- Experience presenting to internal and external customers
- Experience in claims processing and daily operations
- Previous healthcare implementation experience and successful track record in facilitating and consulting across teams
- Excellent communication skills, both oral and written
- Comprehensive knowledge of Microsoft Word and Excel
Preferred Qualifications
- Strong problem solving skills
- Previous RFP experience
- Familiar with RFP databases (RocketDocs)
- Project Management certification
- 3 – 5 years of Medicaid experience
- Must be passionate about contributing to an organization focused on continuously improving consumer experiences
Additional Information
Must have accessibility to high speed DSL or Cable modem for a home office (Satellite internet service is NOT allowed for this role); and recommended speed for optimal performance for Humana systems is 10Mx1M
Vaccination Info
For this job, associates are required to be fully COVID vaccinated or undergo weekly COVID testing and wear a face covering while at work. The weekly testing will need to be done through an approved Humana vendor, and unvaccinated associates should follow all social distancing and masking protocols if they are required to come into a Humana facility or work outside of their home. We are a?healthcare?company committed to putting health and safety first for our members, patients, associates, and the communities we serve.
If progressed to offer, you will be required to:
- Provide proof of full vaccination?or commit to testing protocols OR??
- Provide proof of applicable exemption including any required supporting documentation
- ??Medical, religious, state and remote-only work exemptions are available.
Interview Format
- As part of our hiring process for this opportunity, we may contact you via text message and email to gather more information using a software platform called Modern Hire. Modern Hire Text, Scheduling and Video technologies allow you to interact with us at the time and location most convenient for you.
- If you are selected to move forward from your application prescreen, you may receive correspondence inviting you to participate in a pre-recorded Voice, Text Messaging and/or Video interview. Your recorded interview will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.
- Alert: Humana values personal identity protection. Please be aware that applicants selected for leader review may be asked to provide a social security number, if it is not already on file. When required, an email will be sent from
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with instructions to add the information into the application at Humana’s secure website .
Scheduled Weekly Hours
40