Humana Inc. , headquartered in Louisville, Kentucky, is one of the nation's largest publicly traded health benefits companies. Humana offers a diversified portfolio of health insurance products and related services - through traditional and consumer-choice plans - to employer groups, government-sponsored plans, and individuals. Today, Humana is a leader in consumer engagement.
Throughout its diversified customer portfolio, the company provides guidance that can both help lower costs and lead to a better health plan experience. Gathers, analyzes, assesses and trends pharmacy and medical claim data in order to recommend solutions for cost control and customer medical concerns.
Role Essentials:
- Bachelor Degree in Pharmacy or PharmD preferred from an accredited School of Pharmacy.
- Licensed and registered as pharmacist in Puerto Rico.
- Minimum of five years experience as a Clinical Pharmacist with strong background in clinical interventions.
- Excellent communication skills, both oral and written, English and Spanish
- Team player, ability to work with tight schedules, multiple priorities and overtime.
- Experience in case evaluation, presentations to physicians and solid clinic background related to drugs utilization, formulary compliance.
- Able to identify medication related problems and develop medication related interventions, drug utilization and drug disease management guidelines.
- Drug utilization review and evaluation skills
- Knowledge on electronic claim payment process, computer systems and its application
- Computer literate: experience in Microsoft Office (Word, Excel and Power Point.
