Associate Director, Pharmacy Hub Operations

CenterWell; United States; Teletrabalho; USD 150 000 - 206 000; Tempo integral

Vantagens oferecidas por esta oferta de emprego

Bonus incentive plan

Health benefits

Retirement plan

Resumo da oferta

CenterWell is seeking an Associate Director of Pharmacy Hub Operations to lead the launch and ongoing operation of a comprehensive pharmacy hub. The role oversees intake, enrollment, verification, prior authorization, and patient assistance workflows across Access and Clinical Operations, with a focus on scalable, compliant processes.

The ideal candidate has deep pharmacy operations experience, strong leadership, and the ability to partner across Compliance, Quality, Technology, and external

Qualificações

• Bachelor’s degree in Pharmacy, Nursing, or related clinical field; advanced clinical, business, or healthcare administration degree preferred.
• Active pharmacist or registered nurse license in good standing.
• 5+ years of people leadership experience in complex healthcare operations, including leadership of leaders or multiple operational teams.
• Demonstrated experience with benefits verification, prior authorization, appeals, patient assistance, enrollment, or reimbursement support workflows.
• Experience launching or transforming an operational function, client program, or healthcare workflow.

Responsabilidades

• Launch operating model across Access Operations and initial Clinical Operations.
• Establish integrated launch workflows across access specialists, resolution resources, pharmacists, nurses, and technicians.
• Partner with Implementation on requirements, workflow validation, UAT, training readiness, cutover, go-live, and hypercare.
• Translate requirements and compliance obligations into executable practices.
• Establish staffing, licensing, credentialing, onboarding, and contingency plans.
• Lead intake and enrollment, verification, prior authorization support, appeals coordination, and patient assistance navigation.
• Own service-level attainment, turnaround time, backlog, productivity, and end-to-end access outcomes.
• Provide operational oversight for clinical review, patient education, adherence support, and technician workflows.
• Ensure licensure, credentialing, competency, supervision, and documentation controls.

Conhecimentos

People leadership

Operations leadership

Pharmacy hub operations

Regulatory compliance

Cross-functional collaboration

Formação académica

Pharmacist license (active)

Bachelor’s degree in Pharmacy or related field

Descrição da oferta de emprego

Become a part of our caring community

The Associate Director of Pharmacy Hub Operations is responsible for helping build, launch, and lead the pharmacy hub operating model across patient access and clinical services. During launch, this leader will provide broad operational oversight across the end-to-end model, including intake and enrollment, benefits verification, prior authorization support, appeals coordination, financial assistance navigation, complex access issue resolution, and the initial pharmacist, nurse, and pharmacy technician service capabilities.

The position is intentionally designed for a versatile operations leader who can establish integrated workflows, staffing, readiness, quality controls, escalation pathways, and performance routines across the launch organization. As the hub scales and dedicated leadership structures are established, the role may evolve to lead Access Operations, Clinical Operations, or another major area of Pharmacy Hub Operations based on the leader’s experience and strengths, organizational needs, program mix, operating complexity, and business growth. The role partners closely with Implementation, Service Operations, the Pharmacist-in-Charge, Product, Technology, Quality, Compliance, Workforce Management, Training, Analytics, and external vendors.

The ideal candidate brings deep experience in manufacturer hub services, specialty pharmacy, patient access, reimbursement support, clinical services, or pharmacy operations and demonstrates the range to lead across multiple operational disciplines. Success requires hands‑on launch leadership, disciplined performance management, strong judgment in a regulated environment, and the ability to build scalable teams while adapting leadership scope as the organization matures.

Key Responsibilities

Launch, Operating Model & Readiness

• Build the launch operating model across Access Operations and initial Clinical Operations, including team structure, role clarity, workflows, queue design, escalation paths, controls, and performance routines.
• Establish integrated launch workflows across access specialists, resolution resources, pharmacists, nurses, and pharmacy technicians, including role boundaries, handoffs, coverage, escalation, and governance.
• Partner with Implementation on requirements, workflow validation, user acceptance testing, training readiness, cutover, go‑live, and hypercare; assume operational accountability following formal acceptance.
• Translate manufacturer requirements, business rules, clinical protocols, service‑level commitments, scope‑of‑practice requirements, and compliance obligations into executable practices.
• Establish launch staffing, hiring sequences, licensing and credentialing dependencies, onboarding expectations, and contingency plans.

Access Operations Leadership

• Lead intake and enrollment, benefits verification, prior authorization support, appeals coordination, copay and patient assistance navigation, and access‑related case resolution.
• Own service‑level attainment, turnaround time, backlog, aging, productivity, quality, rework, abandonment, and end‑to‑end access outcomes.
• Implement daily management routines, capacity controls, queue balancing, escalation management, and recovery plans.
• Use operational data to reduce time to therapy, avoidable touches, access delays, and case leakage.

Clinical Operations Launch Oversight

• Provide operational oversight for clinical review, patient education, adherence and persistence support, therapy‑specific outreach, care coordination, and technician‑supported workflows during launch.
• Partner with the Pharmacist-in-Charge and clinical, quality, compliance, legal, and medical leaders on pharmacy policies, patient safety, clinical escalation, adverse‑event and product‑complaint pathways, and regulatory accountability.
• Ensure pharmacist, nurse, and pharmacy technician activities have appropriate licensure, credentialing, competency, supervision, documentation, and scope‑of‑practice controls.
• Establish clinical workload, quality, documentation, intervention, escalation, and patient‑safety measures for launch and early ramp.
• Support the future‑state organizational design and leadership transition as volume, program mix, complexity, and regulatory needs increase; be prepared to assume ongoing leadership of Access Operations, Clinical Operations, or another major hub operating area based on business need and individual fit.

People, Workforce & Quality Leadership

• Recruit, develop, coach, and retain leaders and frontline resources across access and launch‑phase clinical services, while building succession and transition plans for the future‑state organization.
• Set productivity, quality, and competency expectations by work type and discipline; establish calibration, coaching, and performance‑management routines.
• Partner with Workforce Management on staffing, scheduling, shrinkage, overtime, licensed coverage, and capacity plans.
• Partner with Quality and Compliance on monitoring, audit readiness, corrective actions, complaint trends, clinical incidents, and control effectiveness.

Cross‑Functional & Client Partnership

• Represent the integrated Pharmacy Hub Operations model in launch governance, performance reviews, client discussions, and decision forums.
• Coordinate handoffs across Access Operations, Clinical Operations, Service Operations, pharmacy fulfillment, external vendors, and provider‑facing teams as the model matures.
• Partner with Product and Technology on automation, rules configuration, clinical decision support, reporting, AI‑enabled operations, and user‑experience improvements.
• Provide executive updates on readiness, capacity, performance, patient safety, risks, transition triggers, and recovery actions.

Use your skills to make an impact

Required Experience

• Bachelor’s degree in Pharmacy, Nursing, or a related clinical field; advanced clinical, business, or healthcare administration degree preferred.
• Active pharmacist or registered nurse license in good standing.
• 5+ years of people leadership experience in complex healthcare operations, including leadership of leaders or multiple operational teams.
• Demonstrated experience with benefits verification, prior authorization, appeals, patient assistance, enrollment, or reimbursement support workflows.
• Experience in specialty pharmacy, manufacturer hub services, patient support programs, mail‑order pharmacy, clinical contact centers, or complex medication programs.
• Experience launching or materially transforming an operational function, client program, pharmacy service, or healthcare workflow.
• Strong operational acumen in workforce planning, queue management, service‑level performance, quality, root‑cause analysis, corrective action, and risk escalation.
• Strong executive communication and cross‑functional influence in a regulated healthcare environment.

Preferred Experience

• PharmD, MSN, MBA, MHA, board certification, or relevant specialty certification.
• Knowledge of manufacturer program design, financial assistance, payer access pathways, specialty medication journeys, adherence programs, and clinical escalation requirements.
• Experience with hub platforms, clinical workflow tools, automation, analytics, AI‑enabled operations, and digital engagement.
• Experience establishing adverse‑event, product‑complaint, medication‑error, scope‑of‑practice, or clinical quality controls.
• Lean, Six Sigma, project management, change management, or related process‑improvement experience.

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 [e-mail] with instructions on how to add the information into your official application on Humana’s secure website

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. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

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.

$150,000 - $206,300 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, paid parental and caregiver leave), short‑term and long‑term disability, life insurance and many other opportunities.

Application Deadline: 10-22-2026

About us

About CenterWell Pharmacy: CenterWell Pharmacy provides convenient, safe, reliable pharmacy services and is committed to excellence and quality. Through our home delivery and over‑the‑counter fulfillment services, specialty, and retail pharmacy locations, we provide customers simple, integrated solutions every time. We care for patients with chronic and complex illnesses, as well as offer personalized clinical and educational services to improve health outcomes and drive superior medication adherence.

About CenterWell, a Humana company: CenterWell is a leading healthcare services business focused on creating integrated and differentiated experiences that put our patients at the center of everything we do. The result is high‑quality healthcare that is accessible, comprehensive and, most of all, personalized. As the largest provider of senior‑focused primary care, a leading provider of home healthcare and a leading integrated home delivery, specialty, hospice and retail pharmacy, CenterWell is focused on whole health and addressing the physical, emotional and social wellness of our patients. CenterWell is part of Humana Inc. (NYSE: HUM). Learn more about what we offer atCenterWell.com.

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, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.