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Channel Development Lead- Pharmacy Integration – Provider & Market Support - WAH Nationwide




As the Channel Development Lead for the Pharmacy Integration team, you are accountable to provide consistent strategic direction, sales and account management to drive the visibility and utilization of Humana Pharmacy assets (Humana Pharmacy Mail, Humana Specialty Pharmacy, Humana Retail, PrescribeIT) with MAPD markets and assigned provider groups. All of this is driven to maximize the utilization of pharmacy products while building a solid strategy around how HPS/HP/HSP should engage and service the Provider and Medicare business. You will work with a team of high-performing individuals, while driving collaboration across a heavily matrixed environment inside and outside the Humana Pharmacy organization.

The scope of integration partners includes:
•The PBM, which is Humana's captive PBM, Humana Pharmacy Solutions;
•The MAPD markets, which includes Sr. level leadership and personnel engaged in servicing providers;
•The Providers, which includes Humana's network of primary care providers and specialists in fee-for-service, path-to-value, and full capitation payment models; includes independent, IPA and MSO organizational models; includes Humana's owned, JV, alliance and affiliated provider organizations, etc.;
•The Customer Success teams for MAPD and PDP, which is a part of the Pharmacy Clinical Product team within Health Care Services tasked to support the MAPD markets and providers around all things pharmacy;
•The Pharmacies, which includes Humana's captive mail, specialty and retail pharmacies, Humana Pharmacy and PrescribeIT.


Duties & Responsibilities

  • Develop the strategy (operational and sales) and lead a team of associates to build solid awareness of Humana Pharmacy assets within the MAPD and PDP space
  • Take lead in the development of analytics and report needed to support the day-to-day business to include, but not limited to, corporate based meetings, provider meetings, market meetings, etc.
  • Work, in conjunction with the Clinical Pharmacy Leads, market provider engagement teams and market based case managers, to support the MAPD market and provider groups towards a greater integration of Humana Pharmacy into their day-to-day business.
  • Take lead for establishing the value proposition for the markets/providers. Use this value prop to educate Customer Success team and markets supported.
  • Develop, enhance and optimize existing Humana business, member pharmacy referral sources (channels) by Identifying new, unique opportunities that drive incremental growth initiatives
  • Identify, develop and grow new business (channel delivery) partnerships by:
    • Building DRI relationships with key business (channel) leaders: Level 1 - Contact DRI, Level 2 - Business owner DRI
    • Establishing processes and actions needed to leverage new channels in a manner to support their business outcomes.
  • Identify and guide the development of support materials needed enhance member referrals to include but not limited to: Informational pamphlets, educations and training materials, reference documents, contact communications, incentives, etc.
  • Develop a consistent support path and assist in issue resolution for members, markets and providers using the various escalation avenues and reporting back to the appropriate parties.
  • Responsible for submitting global product/process initiatives and be the business owner for the implementation of new programs that are key to the success to the markets and providers
  • Develop and maintain partnerships with key data / technology teams throughout Humana, including but not limited to Pharmacy Analytics, Provider Analytics, Corporate IT, Service Fund, etc.
  • Establish solid metrics needed to gauge successful interaction with key partners

Role Essentials:
  • Bachelor's degree in business, pharmacy, nursing or a related field
  • Experience in healthcare, PBM industry or related business
  • Experience working with physicians/physician groups
  • 5+ years of experience leading and developing a team
  • Experience working in a matrixed environment

Role Desirables:
  • Sales experience
  • Master's degree
  • Project Management Certification

Scheduled Weekly Hours



Senior Level
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