Remote Associate Director, Formulary Operations Management

Humana; Pierre (SD); Remote; USD 126,000 - 174,000; Full time

Benefits offered by this job

Bonus incentive plan

Remote work option

Travel opportunities

Job summary

Humana, Inc. is seeking an Associate Director, Formulary Operations Management to lead the development, governance, and maintenance of pharmacy formularies and utilization management strategies across lines of business.

You will partner with clinical, regulatory, analytics, and product teams to ensure compliant, effective formulary decisions and operational excellence. The role oversees implementation, training, reporting, and continuous improvement of formulary operations, with accountability

Qualifications

• Bachelor's degree OR 6+ years of healthcare, PBM, managed care, health plan, formulary, pharmacy operations, or related experience.
• 2+ years of leadership, management, project leadership, or people leadership experience.
• Experience leading cross-functional initiatives involving multiple stakeholders.
• Strong analytical and problem-solving skills.
• Strong organizational and project management skills.
• Excellent verbal and written communication skills, including executive-level communication.
• Comprehensive knowledge of Microsoft Office applications, including Excel, PowerPoint, Word, and Teams.
• Demonstrated ability to influence and drive organizational outcomes.
• Strong problem solving, critical thinking and analytical skills.
• Must be passionate about contributing to an organization focused on continuously improving consumer experiences.

Responsibilities

• Lead formulary development and maintenance activities across applicable products and lines of business.
• Oversee operational implementation of formulary changes, including coordination with clinical, configuration, product, and operational teams.
• Support the development and execution of utilization management programs, including, but not limited to, prior authorization, step therapy, quantity limits, and coverage
• Evaluate formulary performance and operational impacts through data analysis and reporting.
• Ensure compliance with applicable state, federal, and client formulary requirements.
• Develop and maintain policies, procedures, and supporting documentation for formulary operations.
• Partner with cross-functional stakeholders to support formulary submissions, audits, regulatory reviews, and implementations.
• Lead strategic projects and initiatives related to formulary optimization, operational excellence, and process improvement.
• Lead, develop, and support a high-performing team by setting clear expectations, coaching associates, supporting career development, and fostering accountability, engagement, and collective success.

Skills

Leadership

Analytical skills

Project management

Executive communication

Education

Bachelor's degree

Tools

SQL

Power BI

Tableau

Job description

Humana, Inc. is seeking an Associate Director, Formulary Operations Management to lead the development, governance, and maintenance of pharmacy formularies and utilization management strategies across lines of business.

You will partner with clinical, regulatory, analytics, and product teams to ensure compliant, effective formulary decisions and operational excellence. The role oversees implementation, training, reporting, and continuous improvement of formulary operations, with accountability