UNKNOWN

ADAPTED_NOW

To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested. 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.

YEAR

Become a part of our caring community and help us put health first The Staff Utilization Management Pharmacist (VSP/PT) is a clinical expert responsible for conducting medical necessity and comprehensive medication reviews for prescriptions requiring prior authorization. This role involves evaluating complex clinical scenarios and applying evidence-based criteria to ensure appropriate medication use. The pharmacist addresses moderately complex to complex issues that require critical thinking and in-depth analysis of variable factors. Location:Remote – United States Schedule: This is a VSP (Variable Service Provider) role. The hours will vary between 30-40 hours per week. You must be flexible to work: + 8-hour shifts, Monday through Friday, between 10:30 AM and 11:00 PM EST OR + 10-hour shifts, Tuesday through Friday, between 10:30 AM and 11:00 PM EST + Some weekend coverage may be required + Mandatory overtime during peak season Job Description: The Staff Utilization Management Pharmacist (VSP/PT) is a clinical professional responsible for conducting comprehensive reviews of medication care plans. This includes evaluating medical necessity, analyzing overall utilization, and identifying unusual usage patterns. The pharmacist may intervene and provide clinical guidance to patients and providers to support cost-effective medication use and promote high-quality patient outcomes. Use your skills to make an impact Required Qualifications: + Bachelor’s degree or Doctor of Pharmacy (Pharm.D.) from an accredited college of pharmacy + Active pharmacist license in the state of residence + Eligibility to participate in federal prescription programs (e.g., Medicare/Medicaid) + Self-directed with the ability to work effectively both independently and in a team environment + Strong problem-solving skills and the ability to foster collaborative solutions + High attention to detail with a strong work ethic focused on accuracy and productivity + Excellent verbal and written communication skills + Proficiency with computer systems, including but not limited to: + Microsoft Office Suite (Word, Excel, Outlook) + Clinical decision support tools (e.g., Micromedex, Lexicomp) + Pharmacy benefit management (PBM) platforms + Electronic health records (EHRs) + Passion for contributing to an organization focused on continuously improving the consumer experience Preferred Qualifications: + Experience in managed care pharmacy, particularly in utilization management review ​ Additional Information: Interview Format : As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. WAH Requirements: To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested Satellite, cellular and microwave connection can be used only if approved by leadership Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. SSN Statement: Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from Humana@myworkday.com with instructions on how to add the information into your official application on Humana’s secure website. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. Scheduled Weekly Hours 1 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. $94,900 - $130,500 per year Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers benefits for limited term, variable schedule and per diem associates which are designed to support whole-person well-being. Among these benefits, Humana provides paid time off, 401(k) retirement savings plan, employee assistance program, business travel and accident. 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 protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with 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. Centerwell, a wholly owned subsidiary of 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 full accessibility rights information and language options https://www.partnersinprimarycare.com/accessibility-resources

CenterWell

Staff Utilization Management Pharmacist (VSP/PT)

Humana

Identify, develop, and maintain professional relationships with key opinion leaders (KOL), consultants, investigators, and healthcare professionals (HCPs) in assigned areas of therapeutic interest to ensure communication of current and emerging medical and scientific information, resulting in improvement of optimal patient care and outcomes. The salary range is the range United Therapeutics Corporation in good faith believes is the range of possible compensation for this role at the time of this posting depending on the candidate’s experience, qualifications, geographic location, and other factors permitted by law.

California, US residents click here (https://www.unither.com/docs/UNITHER%20Applicant%20Notice%20-%20%2812-22-23%29%20Final%202.15.24%20Combined%20EN%20and%20French.pdf#page=9) . The job details are as follows: Who We Are We are the first publicly-traded biotech or pharmaceutical company to take the form of a public benefit corporation. Our public benefit purpose is to provide a brighter future for patients through the development of novel pharmaceutical therapies; and technologies that expand the availability of transplantable organs. United Therapeutics (Nasdaq: UTHR) seeks to travel down the corridors of indifference to develop treatments for rare, deadly diseases. We were founded in 1996 by a family seeking a cure for their daughter’s pulmonary arterial hypertension (PAH). Today, we have six FDA-approved therapies that treat PAH, pulmonary hypertension associated with interstitial lung disease (PH-ILD) and neuroblastoma, a rare pediatric cancer. Our near-term pipeline seeks to develop additional therapies for PAH and pulmonary fibrosis (PF). The cure for end-stage life-threatening diseases like PAH, PH-ILD, PF, and many others is an organ transplant, but only a small percentage of donated organs are available to address the vast need. For this reason, we are working to create manufactured organs to address the shortage of kidneys, hearts, lungs, and livers available for transplant. We believe an unlimited supply of tolerable, transplantable organs will eliminate the transplant waiting list and cure end-stage organ diseases for which transplant is not currently an option. Who You Are Are you passionate about pediatric oncology? Join our team as a Clinical Oncology Liaison where you’ll play a key role in bridging the gap between healthcare professionals and oncology treatments. In this position, you’ll build strong relationships with healthcare providers, provide essential education, and share insights on emerging scientific data. Your work will support clinical research, foster meaningful discussions with healthcare providers, and ensure optimal patient care. If you’re ready to make a meaningful impact in pediatric oncology, we’d love to have you on our team! + Identify, develop, and maintain professional relationships with key opinion leaders (KOL), consultants, investigators, and healthcare professionals (HCPs) in assigned areas of therapeutic interest to ensure communication of current and emerging medical and scientific information, resulting in improvement of optimal patient care and outcomes + Serve as field therapeutic area expert, demonstrating high scientific acumen and competency of assigned therapeutic disease states, products, and competitor data + Engage in meaningful scientific exchange with KOLs and obtain clinical insights; capture, synthesize, and deliver HCP-derived scientific insights to internal teams + Serve as an educational resource to help ensure that nurses, pharmacists, physicians and other allied healthcare professionals are sufficiently educated and trained on the safe and effective use of Unituxin (dinutuximab) + Present information and data on oncology products to HCPs including physicians, academic institutions, researchers, and allied health care professionals, that is rigorous, objective, accurate, balanced, and consistent with company policies and procedures + Represent UT Oncology at exhibit booths at regional and national conferences to share appropriate resources and provide education to attendees + Collaborate with internal medical affairs team on medical strategy and medical communication projects + Support investigator sponsored studies by serving as a liaison between investigators and internal medical affairs teams + Lead, support, and execute special projects, programs, and initiatives Minimum Requirements + Bachelor’s degree in a scientific discipline + 5+ years of clinical experience in pediatric oncology + Active Driver License, valid and in good standing + Strong ability to translate complex medical data into clinically relevant information and derive actionable insights + Ability to collaborate in a team environment and partner effectively across geographic areas and cross-functional groups + Ability to travel up to 50%, including overnight travel Preferred Qualifications + Master’s degree or professional degree (DNP, PharmD) + 5+ advanced clinical practice experience in pediatric oncology + Advanced clinical knowledge in pediatric oncology solid tumors + Clinical experience preferably in pediatric oncology working with immunotherapies, specifically Unituxin (dinutuximab) Job Location and Travel This field-based role requires at least 50% travel, including overnight stays. The preferred candidate will be located in the eastern standard time zone; however, we will consider qualified candidates in other time zones within the continental US (Please note: The territory for this position is mostly east coast; if the selected candidate is not located on the East Coast, travel could be higher than 50%). At United Therapeutics, our mission and vision are one. We use our enthusiasm, creativity, and persistence to innovate for the unmet medical needs of our patients and to benefit our other stakeholders. We are bold and unconventional. We have fun, we do good. The salary for this position ranges from $120,000 to $165,000 per year. (In addition, this role is eligible for the Company’s short-term and long-term incentive programs- may not apply to all roles) The salary range is the range United Therapeutics Corporation in good faith believes is the range of possible compensation for this role at the time of this posting depending on the candidate’s experience, qualifications, geographic location, and other factors permitted by law. The Company may ultimately pay more or less than the posted range. This range may be modified in the future. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law. Eligible employees may participate in the Company’s comprehensive benefits suite of programs, including medical / dental / vision / prescription coverage, employee wellness resources, savings plans (401k and ESPP), paid time off & paid parental leave benefits, disability benefits, and more. For additional information on Company benefits, please visit https://www.unither.com/careers/benefits-and-amenities United Therapeutics Corporation is an Equal Opportunity Employer, including veterans and individuals with disabilities. _We strive to be an organization that engages the minds, hearts, and most spirited efforts of each of our employees. Our sense of purpose transforms what we do from work into mission, occupation into vocation and achievement into success._ _We challenge our employees with innovative and revolutionary projects, offer an environment which fosters high-level job performance and provide a highly competitive total rewards package. This is what makes United Therapeutics a stimulating place to work._

United Therapeutics

Clinical Oncology Liaison

Work at home requirements : To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. The Pharmacy Director, internally known as a Clinical Pharmacy Lead, plans, directs, and monitors all financial, operational, professional, and clinical activities for the purposes of pharmacy program development for our Fully Integrated Dual Eligible Special Needs Plan (FIDE-SNP) Michigan Medicare - Medicaid health plan.

Become a part of our caring community and help us put health first The Clinical Pharmacist Lead monitors drug development pipeline, and medical literature, while providing clinical support for internal stakeholders. Utilizes broad understanding of managed care and PBM knowledge to develop, and/or implement strategies and programs to mitigate cost trend and improve health outcomes. The Clinical Pharmacist Lead works on problems of diverse scope and complexity ranging from moderate to substantial. The Pharmacy Director, internally known as a Clinical Pharmacy Lead, plans, directs, and monitors all financial, operational, professional, and clinical activities for the purposes of pharmacy program development for our Fully Integrated Dual Eligible Special Needs Plan (FIDE-SNP) Michigan Medicare - Medicaid health plan. The individual leverages a broad understanding of managed care and pharmacy benefit management (PBM) to develop and implement strategies and programs that drive trends and improve health outcomes. They ensure the pharmacy department provides optimal pharmaceutical services that meet all legal, accreditation, and certification requirements. This position will coordinate day-to-day pharmacy operations directly with the plan Chief Executive Officer and Chief Medical Officer. POSITION RESPONSIBILITIES: + Keeps current with State and Federal regulations regarding the practice of Pharmacy and implements changes as necessary to maintain compliance supporting both the business and public relations strategies. + Develops corporate communications to be shared with senior leadership. + Supports trend management by conducting analysis of drug spend, utilization, and/or approval scenarios. + Advises executives to develop functional strategies (often segment specific) on matters of significance. + Exercises independent judgment and decision making on complex issues regarding job duties and related tasks. + Works under minimal supervision, using independent judgment requiring analysis of variable factors and determining the best course of action. + Facilitates and consults across teams and managing projects working collaboratively and communicating with staff in different positions and all levels of management positions + Manages the Humana Michigan FIDE-SNP health plan relationship with our internal PBM, Humana Pharmacy Solutions ensuring compliance with programmatic requirements, such as claims processing, prior authorization, formulary management and clinical programming + Represents Humana at all Pharmacy Medicaid meetings including those with the Michigan Department of Health and Human Services (MDHHS) Use your skills to make an impact Required Qualifications + Bachelor’s degree in Pharmacy or Doctor of Pharmacy (PharmD) + Michigan-licensed pharmacist residing or willing to relocate to Michigan + Minimum of ten plus years of Pharmacy Experience with at least three years’ experience in managed care and/or PBM operations + Ability to travel 10% of time + 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 Preferred Qualifications + Master's degree in public health, Business Administration or a related field + Board Certified Specialty Pharmacist + Experience with Microsoft Access & Microsoft Project + Experience with data analytics Additional Information: As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. Work at home requirements : To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. Satellite, cellular and microwave connection can be used only if approved by leadership. Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. SSN Alert: Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from Humana@myworkday.com with instructions on how to add the information into your official application on Humana’s secure website. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. 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. $126,300 - $173,700 per year This 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 protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with 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 https://www.humana.com/legal/accessibility-resources?source=Humana_Website.

Medicare-Medicaid Pharmacy Director

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Staff Utilization Management Pharmacist (VSP/PT)CenterWell

Clinical Oncology LiaisonUnited Therapeutics

Medicare-Medicaid Pharmacy DirectorHumana

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