Senior Formulary Operations Leader — Remote

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

Job summary

Humana is seeking an Associate Director of Formulary Operations Management to lead development, governance, and maintenance of pharmacy formularies across business lines. You will collaborate with clinical, regulatory, analytics, and product teams to ensure compliant, effective formulary decisions while driving operational excellence.

The role requires leadership of a high-performing team, strong data analytics, and strategic project execution.

Qualifications

• Bachelor's degree or 6+ years of healthcare, PBM, managed care, or related experience.
• Experience leading cross-functional initiatives involving multiple stakeholders.
• Strong analytical and problem-solving skills.
• Strong organizational and project management skills.
• Ability to manage multiple priorities and deadlines in a fast-paced environment.
• 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.
• Passion for 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 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 experience

Cross-functional initiatives

Analytical skills

Organizational skills

Project management

Prioritization

Communication skills

MS Office

Influencing

Critical thinking

Customer focus

Education

Bachelor's degree

Tools

Power BI

Tableau

SQL

Job description

Humana is seeking an Associate Director of Formulary Operations Management to lead development, governance, and maintenance of pharmacy formularies across business lines. You will collaborate with clinical, regulatory, analytics, and product teams to ensure compliant, effective formulary decisions while driving operational excellence.

The role requires leadership of a high-performing team, strong data analytics, and strategic project execution.