Pharmacy Contracting Executive_

Madison

**Become a part of our caring community and help us put health first**

The Pharmacy Contracting Executive ensures contract compliance and performs analysis regarding pharmacy claims and contracts to design, build, and maintain Humana's pharmacy networks

The Pharmacy Contracting Executive ensures contract compliance and performs analysis regarding pharmacy claims and contracts to design, build, and maintain Humana's pharmacy networks. Exercises independent judgment and decision making on complex issues regarding job duties and related tasks and collaborates with numerous teams across the organization regarding network setups. Uses independent judgment requiring analysis of variable factors and determining the best course of action and implementation ensuring accurate and reliable claims adjudication. Works alongside SS&C, Humana's claim processor, to test and advise on network design based on business need and contractual expectations. Creates and analyzes test cases and claims data to inform and recommend critical business decisions.

**Use your skills to make an impact**

**Required Qualifications**

+ 5 or more years' experience in pharmacy setups including development, implementation, and maintenance

+ Extensive knowledge of pharmacy plans and how Humana's pharmacy network setups connect and interact with other areas across the organization (e.g., benefits, formulary, etc.)

+ Proficiency with Microsoft Access and Excel

+ Strong financial acumen with proficiency in analyzing and interpreting data

+ Ability to manage multiple tasks and deadlines with attention to detail

+ Ability to communicate effectively and deliver presentations to senior management and external business partners

+ Able to give direction and make sound business decisions

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

**Preferred Qualifications**

+ Bachelor's Degree

+ 5 or more years' experience with pharmacy contracting and pricing

+ Familiarity with CMS' Plan Finder application and RxIntel

+ Process improvement experience

**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.$84,600 - $116,300 per yearThis 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 for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides 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 and many other opportunities.

**About us**

Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.

**Equal Opportunity Employer**

It is the policy of  Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or because he or she is a protected veteran. It is also the policy of  Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our umana.com/legal/accessibility-resources?source=Humana_Website.