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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in formulary development, operational implementation, and compliance with regulatory requirements while leading cross-functional teams to optimize performance and enhance consumer experiences.
Highest-signal resume keywords
Formulary DevelopmentLeadership ExperienceData AnalysisProject ManagementRegulatory Compliance
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Formulary OperationsHealthcare ExperiencePharmacy Benefit ManagementOperational ExcellenceProcess ImprovementUtilization ManagementAnalytical SkillsProblem-Solving SkillsPolicy DevelopmentDocumentation
Soft Skills
Communication SkillsOrganizational SkillsTeam LeadershipStakeholder EngagementInfluencing Skills
Tools & Technologies
Microsoft ExcelMicrosoft PowerPointMicrosoft WordMicrosoft Teams
Industry Keywords
Managed CareHealth PlanPharmacy OperationsCompliancePHI/HIPAA
About the role
Key responsibilities & impact- Lead formulary development and maintenance activities across applicable products and lines of business
- Oversee operational implementation of formulary changes with clinical, configuration, product, and operational teams
- Support 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 state, federal, and client formulary requirements
- Develop and maintain policies, procedures, and supporting documentation for formulary operations
- Partner with stakeholders on formulary submissions, audits, regulatory reviews, and implementations
- Lead strategic initiatives related to formulary optimization, operational excellence, and process improvement
- Lead, develop, and support a high-performing team through expectations-setting, coaching, career development, accountability, and engagement
- Manage formulary operations workflow, quality, capacity, training, reporting, issue resolution, and people leadership
- Work standard Eastern Time business hours
Requirements
What you’ll need- Bachelor's degree OR 6 or more years of healthcare, pharmacy benefit management (PBM), managed care, health plan, formulary, pharmacy operations, or related experience
- 2 or more years of leadership, management, project leadership, or people leadership 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
- Passion for contributing to an organization focused on continuously improving consumer experiences
- Self-provided internet service with at least 25 Mbps download and 10 Mbps upload speed
- Dedicated work space without ongoing interruptions to protect member PHI/HIPAA information
Benefits
Comp & perks- Bonus incentive plan based on company and/or individual performance
- Medical benefits
- Dental benefits
- Vision benefits
- 401(k) retirement savings plan
- Paid time off
- Company holidays
- Personal holidays
- Paid parental leave
- Paid caregiver leave
- Short-term disability
- Long-term disability
- Life insurance
- Remote work
- Occasional travel to Humana offices for training or meetings