We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary The Lead Director, Corporate Communications will support the business objectives of the Chief Pharmacy Officer and Head of Specialty Operations by helping to develop and lead the execution of a communications strategy that advances key business and enterprise priorities. This role will drive communications in support of CVS Specialty’s business objectives while also leading executive communications, thought leadership opportunities, and content development that strengthen the voice and visibility of the Chief Pharmacy Officer across internal and external channels. The Lead Director will help shape communications that advocate for the evolving role of the pharmacist and advance the practice of pharmacy in alignment with the education and training of these professionals. In addition, this role will support communications strategy and execution for CVS Specialty, helping translate business priorities into clear, compelling messaging that underscores key differentiators of the business, including its focus on simplifying the patient experience, optimizing clinical outcomes through expert care and personalized support, and improving experiences through market-leading innovation and technology. This role requires a highly skilled communications leader who can counsel senior executives, translate complex healthcare and business issues into clear and compelling messaging, and o
Salary not disclosed
Check market pay for comparable Clinical Pharmacist Lead roles before applying.
Role overview
Job description
Become a part of our caring community
The Clinical Programs Pharmacist Lead will be a part of a collaborative Pharmacy Stars team which is accountable for Humana’s Stars patient safety measure performance. The Clinical Pharmacist Lead autonomously develops, implements, and manages clinical program strategies to improve Medicare members' medication adherence and appropriate medication use. The Clinical Pharmacist lead exercises independent judgment and decision making on complex issues regarding job duties and related tasks, works under minimal supervision, and analyzes variable factors to determine the best course of action.
Use your skills to make an impact
Required Qualifications
- Degree of Doctor of Pharmacy (PharmD or RPh) from an accredited School of Pharmacy
- Active, unrestricted pharmacy licensure
- 5+ years of clinical experience in managed care or pharmacy related field, or equivalent
- Proficient in Microsoft Office applications (especially Word, Excel, and PowerPoint)
- Excellent written and oral communication skills
- Thrives in a fast paced, multi-project work environment while still ensuring attention to detail
- Successful track record in facilitating and consulting across teams and managing projects
- Strategic thinking and planning capabilities, organized, and detail-oriented
- Ability to learn quickly, work under pressure and timeline, work with ambiguity, and make complex decisions as necessary to meet business need
- Ability to assimilate, analyze, draw conclusions, and make recommendations from complex data
Preferred Qualifications
- Previous experience in Medicare Stars
- Managed care and/or community pharmacy experience or residency/fellowship
- Previous experience in clinical program development and leadership
- Master’s Degree in Business, Healthcare Administration, or related field
- 2+ years in project management or leadership experience
Additional Information:
As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.
Work at home requirements:
To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:
At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested.
Satellite, cellular and microwave connection can be used only if approved by leadership.
Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.
Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.
SSN Alert:
Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from Humana@myworkday.com with instructions on how to add the information into your official application on Humana’s secure website.
Work at Home Requirements: To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
Scheduled Weekly Hours
40Pay Range
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
Description of Benefits
Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.Application Deadline: 10-01-2026
About us
About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at Humana.com and at CenterWell.com.
Equal Opportunity Employer
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
What they are looking for
Skills & requirements
Qualification
Degree of Doctor of Pharmacy (PharmD or RPh) from an accredited School of Pharmacy
Hiring company
Humana
Explore this employer's active roles, salary signals and company profile on Jobiba.
Keep exploring
Similar active roles
Fresh roles matched to this title and market.
$108.6K – $250.7K/yr
Founded in 1849, Pfizer Inc. began as a small chemistry enterprise built on the belief that scientific ingenuity can improve—and protect—human life. Today, as one of the world’s leading biopharmaceutical companies, Pfizer’s purpose is Breakthroughs that change patients’ lives : discovering, developing, and delivering medicines and vaccines that address unmet need, earn trust through quality and integrity, and reach patients through strong partnerships across the healthcare system. In a complex and rapidly evolving pharmaceutical landscape, our work is measured by one outcome - helping patients live longer, healthier lives . Rare Disease Hemophilia Sales Organization Mission & Impact Pfizer’s Rare Disease – Hemophilia Sales organization exists to help improve the lives of people living with hemophilia by connecting scientific innovation to the clinicians and systems that deliver care. We lead with integrity and patient need—promoting Pfizer Hemophilia therapies compliantly, helping customers understand appropriate use, and reducing access and care coordination barriers so more patients can start and stay on the right therapy. Our impact is better, more consistent outcomes for patients and a higher standard of care across the hemophilia community. Patient impact in rare disease: Support appropriate diagnosis, referral to Hemophilia Treatment Centers (HTCs) where applicable, initiation, and persistence by engaging hematologists, HTC multidisciplinary teams, and allied care partners involved in bleeding disorder management. Disease education grounded in evidence: Reinforce evidence-based value narratives using approved materials to support informed clinical decision-making in hemophilia. Coordinated care pathways & access: Partner across the matrix and with HTCs, specialty pharmacies, payers, and ancillary sites to simplify starts, reimbursement navigation, and continuity
$108.6K – $250.7K/yr
Founded in 1849, Pfizer Inc. began as a small chemistry enterprise built on the belief that scientific ingenuity can improve—and protect—human life. Today, as one of the world’s leading biopharmaceutical companies, Pfizer’s purpose is Breakthroughs that change patients’ lives : discovering, developing, and delivering medicines and vaccines that address unmet need, earn trust through quality and integrity, and reach patients through strong partnerships across the healthcare system. In a complex and rapidly evolving pharmaceutical landscape, our work is measured by one outcome - helping patients live longer, healthier lives . Rare Disease Hemophilia Sales Organization Mission & Impact Pfizer’s Rare Disease – Hemophilia Sales organization exists to help improve the lives of people living with hemophilia by connecting scientific innovation to the clinicians and systems that deliver care. We lead with integrity and patient need—promoting Pfizer Hemophilia therapies compliantly, helping customers understand appropriate use, and reducing access and care coordination barriers so more patients can start and stay on the right therapy. Our impact is better, more consistent outcomes for patients and a higher standard of care across the hemophilia community. Patient impact in rare disease: Support appropriate diagnosis, referral to Hemophilia Treatment Centers (HTCs) where applicable, initiation, and persistence by engaging hematologists, HTC multidisciplinary teams, and allied care partners involved in bleeding disorder management. Disease education grounded in evidence: Reinforce evidence-based value narratives using approved materials to support informed clinical decision-making in hemophilia. Coordinated care pathways & access: Partner across the matrix and with HTCs, specialty pharmacies, payers, and ancillary sites to simplify starts, reimbursement navigation, and continuity
$108.6K – $250.7K/yr
Founded in 1849, Pfizer Inc. began as a small chemistry enterprise built on the belief that scientific ingenuity can improve—and protect—human life. Today, as one of the world’s leading biopharmaceutical companies, Pfizer’s purpose is Breakthroughs that change patients’ lives : discovering, developing, and delivering medicines and vaccines that address unmet need, earn trust through quality and integrity, and reach patients through strong partnerships across the healthcare system. In a complex and rapidly evolving pharmaceutical landscape, our work is measured by one outcome - helping patients live longer, healthier lives . Rare Disease Hemophilia Sales Organization Mission & Impact Pfizer’s Rare Disease – Hemophilia Sales organization exists to help improve the lives of people living with hemophilia by connecting scientific innovation to the clinicians and systems that deliver care. We lead with integrity and patient need—promoting Pfizer Hemophilia therapies compliantly, helping customers understand appropriate use, and reducing access and care coordination barriers so more patients can start and stay on the right therapy. Our impact is better, more consistent outcomes for patients and a higher standard of care across the hemophilia community. Patient impact in rare disease: Support appropriate diagnosis, referral to Hemophilia Treatment Centers (HTCs) where applicable, initiation, and persistence by engaging hematologists, HTC multidisciplinary teams, and allied care partners involved in bleeding disorder management. Disease education grounded in evidence: Reinforce evidence-based value narratives using approved materials to support informed clinical decision-making in hemophilia. Coordinated care pathways & access: Partner across the matrix and with HTCs, specialty pharmacies, payers, and ancillary sites to simplify starts, reimbursement navigation, and continuity
We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary This position is for a Clinical Pharmacist working in the Prior Authorization team. - Collaborates with the technicians and prior authorization team members to process referrals, including answering clinical questions and collecting appropriate clinical/medical data needed to perform clinical assessments and reviews as per the health plan/employer-agreed criteria within the designated service level agreements. - Evaluate and review all prior authorization requests and render coverage determinations based on clinical criteria and plan design. Includes verifying insurance coverage and eligibility, interpreting clinical guideline criteria, consulting physicians and other healthcare providers, and appropriately utilizing clinical knowledge and resources while complying with department protocols. - One of the crucial responsibilities is to guarantee that the decisions regarding cases are conveyed promptly and efficiently to all the healthcare providers, health plans/employers, patients, and other healthcare professionals following agreed-upon approval & denial management processes. - Performs and handles inbound and outbound phone calls with technicians, prior authorization team members, physicians, healthcare providers, and/or patients to facilitate prior authorization requests, answer inquiries, and/or resolve escalations. - Establishes and maintains communicat
We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary Ready to take your clinical skills to the next level? Check out this outstanding opportunity for a Medicaid Prior Authorization Pharmacist with Aetna! This is a Clinical Pharmacist position supporting Medicaid Prior Authorization. An active TX or AZ pharmacist license that is in good standing is required. New hire is required to obtain the secondary license (AZ or TX) within 90 days of hire . We are hiring for the 10:30 am - 7:00 pm CST shift (post training). The training schedule is: 10:00 am - 6:30 pm CST. You will be required to work one Saturday every 4-6 weeks and occasional holidays. This is a fully remote position open to qualified candidates within the United States who currently hold active, unrestricted TX or AZ pharmacist licensure. Required Qualifications - Active and unrestricted TX and/or AZ pharmacist license - New hire is required to obtain the secondary license (AZ or TX) within 90 days of hire . - Demonstrated experience with clinical decision-making while applying evidence-based clinical guidelines/criteria; utilizing formularies/preferred drug lists. - Experience working in a high production, remote team environment - 3+ years experience working as a pharmacist or completion of PGY1 managed care residency, includin
🔔 Get job alerts
New Clinical Pharmacist Lead - Pharmacy Stars jobs in Nationwide, United States, straight to your inbox.
No spam · Unsubscribe anytime