Senior Formulary Operations Leader - Remote

Humana, Inc.; United States; Remote; USD 126,000 - 174,000; Full time

Benefits offered by this job

Bonus incentive plan

Job summary

Humana, Inc. is seeking an Associate Director, Formulary Operations Management to lead development, governance, and implementation of formularies across lines of business.

This remote nationwide role partners with clinical, regulatory, analytics, and product teams to ensure alignment with regulatory requirements and organizational goals. The Associate Director will oversee utilization management programs, drive operational excellence, and lead a high-performing team with clear expectations,

Qualifications

• 6+ years in healthcare, PBM, managed care, health plan, formulary, or pharmacy operations
• 2+ years of leadership, management, or people leadership experience
• Experience leading cross-functional initiatives with multiple stakeholders
• Strong analytical and problem-solving skills
• Strong organizational and project management skills
• Excellent verbal and written communication skills, including executive-level communication
• Knowledge of Microsoft Office applications (Excel, PowerPoint, Word, Teams) and ability to influence outcomes

Responsibilities

• Lead formulary development and maintenance across products and lines of business
• Oversee operational implementation of formulary changes with clinical, configuration, product, and operational 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 and maintain policies for formulary operations
• Partner with stakeholders for submissions, audits, regulatory reviews, and implementations
• Lead strategic projects related to formulary optimization and process improvement
• Coach and develop a high-performing team, driving accountability and engagement

Skills

Healthcare PBM experience

Leadership

Cross-functional leadership

Analytical skills

Project management

Executive communication

Microsoft Excel

PowerPoint

Word

Teams

Education

Bachelor's degree

Tools

Microsoft Excel

Power BI

Tableau

Job description

Humana, Inc. is seeking an Associate Director, Formulary Operations Management to lead development, governance, and implementation of formularies across lines of business.

This remote nationwide role partners with clinical, regulatory, analytics, and product teams to ensure alignment with regulatory requirements and organizational goals. The Associate Director will oversee utilization management programs, drive operational excellence, and lead a high-performing team with clear expectations,