Humana Looking For Specialty Drug Site of Care Specialist at Cincinnati, OH Full Time

The Specialty Pharmacy Programs Clerk 2 supports clinical programs and comprehensive insights directly related to Specialty Pharmacy products and tools that support the Specialty Pharmacy Strategy. The Specialty Pharmacy Programs Clerk 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on semi-routine assignments.

Responsibilities

The Specialty Pharmacy Programs Clerk 2 integrates clinical and educational services customized to individual needs and treatment goals, including therapies for chronic and complex illnesses. Verifies that medications meet manufacturer and dosing guidelines. Decisions are typically focused on interpretation of area/department policy and methods for completing assignments. Works within defined parameters to identify work expectations and quality standards, but has some latitude over prioritization/timing, and works under minimal direction. Follows standard policies/practices that allow for some opportunity for interpretation/deviation and/or independent discretion.

In this role, you will:
Review claims related data, analyze and identify trends

Review member eligibility to receive home infusion drug therapy

Outreach to members and providers

Communicate with leadership through weekly meetings with infusion partners

8:30am to 5:00pm EST M-F.

Required Qualifications

1 year of technical experience

Strong organizational skills and ability to stay on schedule

Ability to work independently

Excellent customer orientation and service skills

Proficient PC skills including Microsoft Office, Teams, Zoom, other technology

Foundational skill in using Access

Confident ability using Excel to pull reports, extract data and interpret information

Must be passionate about contributing to an organization focused on continuously improving consumer experience

Experience working with external partners/vendors

Preferred Qualifications

Bachelors Degree

Familiarity with Humana’s operating systems

Specialty pharmacy experience

Experience with prior authorizations

Additional Information

Must have accessibility to high speed DSL or Cable modem for a home office (Satellite internet service is NOT allowed for this role); and recommended speed for optimal performance for Humana systems is 10Mx1M

Vaccination Info

For this job, associates are required to be fully COVID vaccinated or undergo weekly COVID testing and wear a face covering while at work. The weekly testing will need to be done through an approved Humana vendor, and unvaccinated associates should follow all social distancing and masking protocols if they are required to come into a Humana facility or work outside of their home. We are a healthcare company committed to putting health and safety first for our members, patients, associates, and the communities we serve.

If progressed to offer, you will be required to:
Provide proof of full vaccination or commit to testing protocols OR

Provide proof of applicable exemption including any required supporting documentation

Medical, religious, state and remote-only work exemptions are available.

Interview Format:
As part of our hiring process for this opportunity, we will be using an exciting new technology called Modern Hire to enhance our hiring and decision-making ability. Modern Hire allows us to quickly connect and gain valuable information for you pertaining to your relevant skills and experience at a time that is best for your schedule.

If you are selected for a first round screening, you will receive an email correspondence inviting you to participate in a Modern Hire process. You will have a set of questions and you will provide recorded video responses to each question. You should anticipate this to take about 15 – 20 minutes. Your recorded answers will be reviewed and you will subsequently be informed if you will be moving forward to next round.

Alert: Humana values personal identity protection. Please be aware that applicants selected for leader review may be asked to provide a social security number, if it is not already on file. When required, an email will be sent from [email protected] with instructions to add the information into the application at Humana’s secure website.

Scheduled Weekly Hours

40