Pharmacy Hub Operations Lead - Remote Launch

Humana Inc

Topeka (KS)

On-site

USD 150,000 - 206,000

Full time

7 days ago

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Job summary

Humana, Inc. invites applications for Associate Director of Pharmacy Hub Operations.

This role leads the launch and ongoing operate model across Access and Clinical Operations, coordinating with Implementation, Quality, Compliance, and external vendors to build scalable hub services. The ideal candidate has pharmacy or nursing licensure, 5+ years of healthcare operations leadership, and experience with benefits verification, prior authorization, and patient assistance programs.

Qualifications

Bachelor’s degree in Pharmacy, Nursing, or related clinical field; advanced degree preferred.
Active pharmacist or RN license in good standing.
5+ years of people leadership in complex healthcare operations.
Experience with benefits verification, prior authorization, appeals, patient assistance, enrollment workflows.
Experience launching or transforming an operational healthcare function.

Responsibilities

Build the launch operating model across Access Operations and initial Clinical Operations.
Establish integrated launch workflows across access specialists, resolution resources, pharmacists, nurses, and pharmacy technicians.
Partner with Implementation on requirements, workflow validation, user acceptance testing, training readiness, cutover, go-live, and hypercare; assume operational accountability after acceptance.
Translate manufacturer requirements, business rules, clinical protocols, SLAs, scope-of-practice, and compliance into executable practices.
Establish launch staffing, licensing/credentialing dependencies, onboarding expectations, and contingency plans.
Lead intake and enrollment, benefits verification, prior authorization support, appeals coordination, copay navigation, and patient assistance.
Own service-level attainment, turnaround time, backlog, aging, productivity, quality, rework, 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.
Provide operational oversight for clinical review, patient education, adherence support, and clinician-led workflows.