Remote Pharmacy Hub Operations Lead (Launch)

Humana Inc; Annapolis (MD); Remote; USD 150,000 - 206,000; Full time

Job summary

Humana Inc. is seeking an Associate Director of Pharmacy Hub Operations to build, launch, and lead the hub operating model across patient access and clinical services.

You will oversee intake, benefits verification, prior authorization support, and clinical workflows during launch, with scalable teams and strong governance. Ideal candidates have 5+ years of healthcare operations leadership, licensed pharmacists or RNs, and experience in specialty pharmacy or reimbursement support, with proven

Qualifications

• 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.
• 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 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.

Responsibilities

• 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.
• 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.
• 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 leaders on policies, patient safety, clinical escalation, adverse-event and product-complaint pathways, and regulatory accountability.
• Ensure pharmacist, nurse, and pharmacy technician activities have licensure, credentialing, competency, supervision, documentation, and scope-of-practice controls.
• Establish clinical workload, quality, documentation, intervention, escalation, and patient-safety measures for launch and ramp.
• Support future-state organizational design and leadership transition as volume and complexity increase; be prepared to assume ongoing leadership of Access Operations, Clinical Operations, or other hub area.

Skills

Pharmacy operations

Leadership

Clinical workflows

Regulatory compliance

Stakeholder communication

Education

Bachelor’s degree in Pharmacy or related clinical field

Licensed pharmacist or RN

Tools

Hub operations platforms

Job description

Humana Inc. is seeking an Associate Director of Pharmacy Hub Operations to build, launch, and lead the hub operating model across patient access and clinical services.

You will oversee intake, benefits verification, prior authorization support, and clinical workflows during launch, with scalable teams and strong governance. Ideal candidates have 5+ years of healthcare operations leadership, licensed pharmacists or RNs, and experience in specialty pharmacy or reimbursement support, with proven