Remote Associate Director, Formulary Operations

Humana; City of Albany (NY); Remote; USD 126,000 - 174,000; Full time

Benefits offered by this job

Medical benefits

Dental benefits

Vision benefits

401(k) plan

Paid time off

Job summary

Humana, Inc. seeks an Associate Director, Formulary Operations Management to lead development and governance of pharmacy formularies across lines of business, collaborating with clinical, regulatory, analytics, and product teams to ensure compliant, effective formulary decisions.

This role oversees utilization management initiatives, supports regulatory submissions, and leads a high-performing team, with standard Eastern Time business hours and occasional travel as needed.

Qualifications

• Bachelor's degree or 6+ years in healthcare PBM, managed care, or related field.
• 2+ years of leadership or people leadership experience.
• Experience leading cross-functional initiatives with multiple stakeholders.
• Strong analytical, organizational, and project management skills.
• Excellent verbal and written communication, including executive-level communication.

Responsibilities

• Lead formulary development and maintenance across products and lines of business.
• Oversee operational implementation of formulary changes with clinical, configuration, product, and operations teams.
• Support utilization management programs (prior authorization, step therapy, quantity limits, coverage).
• Evaluate formulary performance through data analysis and reporting.
• Ensure compliance with state, federal, and client requirements.
• Develop policies and procedures for formulary operations.
• Partner with stakeholders for submissions, audits, and regulatory reviews.
• Lead strategic projects on formulary optimization and process improvement.
• Lead, develop, and coach a high-performing team.

Skills

Leadership

Cross-functional collaboration

Analytical thinking

Project management

Communication (executive level)

Microsoft Office (Excel, PowerPoint, 等

Influence and stakeholder management

Problem solving

Education

Bachelor's degree

Master's degree in healthcare admin / MBA / public health / health policy

Tools

SQL

Power BI

Tableau

Job description

Humana, Inc. seeks an Associate Director, Formulary Operations Management to lead development and governance of pharmacy formularies across lines of business, collaborating with clinical, regulatory, analytics, and product teams to ensure compliant, effective formulary decisions.

This role oversees utilization management initiatives, supports regulatory submissions, and leads a high-performing team, with standard Eastern Time business hours and occasional travel as needed.