Humana is seeking a proven healthcare executive focused on leadership, culture and strategic business development with extensive quality measure performance experience. Demonstrated ability to define vision and strategy, drive transformation, achieve objectives, attract, develop and retain top talent. This leader will work and collaborate with leaders across the Humana enterprise, Humana Pharmacy Solutions executive leaders as well as partner incredibly closely with our broader Stars leadership team.
This role is responsible for leading an organization with a mission to improve our members health outcomes via optimized medication use. The right candidate exemplifies a balanced approach of business acumen and deep clinical knowledge and optimizes his/her resources by building a culture of accountability, high performance, and collaboration. In addition, this leader will utilize a broad understanding of managed care and PBM practice to develop, implement, and optimize strategies and programs to driver best in class quality measure performance and provider engagement.
Responsibilities
Owns the clinical program strategy for Pharmacy Stars quality measure performance, including end-to-end Pharmacy Stars strategy and execution. This is inclusive of ongoing innovation to drive improvement in existing measures, preparation for measures on display and a commitment to ongoing performance improvement.
Partners and collaborates with executive level leaders in the Retail organization to align programmatic and experience driven strategies to improve Stars performance.
Serves as a key point of contact between our Medicare Stars team, and Retail Clinical Strategy team and pharmacy; partners beyond the patient safety domain to drive Stars performance across the enterprise.
Supports our Opioid focused clinical programs.
Drives our Medication Therapy Management (MTM) strategy, delivering value and operational efficiency via strong vendor management.
Oversite of pharmacy provider engagement strategy; driving Stars performance and optimization of medication therapy for Humana plan members.
Serves as a relationship owner externally for Pharmacy Quality Alliance- a key organization that influences CMS for quality measures that become part of the Stars program
Leads vendor strategy to drive performance and operational efficiency across all clinical programs.
Leads retail pharmacy partnership strategy to drive performance
Partners closely with Retail and Centerwell partners to drive enterprise value and health outcomes.
Invests in the growth and development of associates.
Integrates across the broader pharmacy organization to amplify the enterprise value of pharmacy.
Prepare executive level communications, speaking to team performance and enterprise collaboration
Effectively manages program budget
Key Competencies
Leads Change: Models agility, adaptability and an openness to new ways of thinking and operating. Guides and energizes others to embrace new opportunities arising from change. Inspires strong organizational performance through periods of transformation, ambiguity, and complexity.
Leads Positively: Leads by example to cultivate a climate of motivation, positive energy and meaning in work. Empowers and guides associates to take personal responsibility, encouraging them to productively learn, flourish, and strengthen team capacity. Assesses, selects, recognizes, and develops diverse talent to capitalize on competencies, ideas and passions.
Drives for Excellence: You are a continuous learner who encourages others to learn. By constantly upgrading your own work, you achieve results and outperform the competition
Builds Trust: You honor your word by doing what you say you are going to do
Collaborates: Engages others by gathering multiple views and being open to diverse perspectives, focusing on a shared purpose that puts Humana's overall success first. Develops and strengthens networks and relationships, both inside and outside the organization, that support company performance. Proactively and transparently contributes information and energy toward creating value with others.
Implementation/Execution: You are good at organizing and managing multiple priorities and/or projects by using appropriate methodologies and tools. Develops and optimizes end-to-end processes
Problem Solving: You are a problem solver with the ability to encourage others in collaborative problem solving. Acting as both a broker and consultant regarding resources, you engage others in problem solving without taking over.
Capacity Planning: Determines the requirements of a system, process, or work unit. Plans, analyzes and optimizes capacity to satisfy business requirements, predicts and mitigates constraints, plans enhancements to existing systems, processes or work unit capacity, and determines necessary resources required to provide adequate stability and performance in the most cost effective manner
Required Qualifications
5+ years of experience in managed care or equivalent experience
2+ years of quality measure experience or equivalent experience
5+ years of leadership experience
Strong track record of driving solutions that achieved clinical and financial outcomes
Complex and innovative problem-solving, analytical, critical and strategic thinking capabilities; knows how to create options and then converge on solutions
Exceptional cross-functional collaboration, relationship management, influencing, and interpersonal skills
Very disciplined; has the ability to manage competing priorities and operate effectively within a large and complex organizational structure
Ability to engage, educate, influence and guide matrixed teams at all levels on the concepts, opportunities and strategy of managing traditional and specialty medications
Able to articulate vision, mobilize teams, and deliver results
Strong delegation and decision-making skills
Success in leading teams- effectively coaching, developing and leading, including direct-reports and matrixed functions
Impeccable oral and written communication skills, as well as the polish, poise, and executive presence to effectively interact with and present to executives, external partners, and senior-level stakeholders
Preferred Qualifications
MBA, MPH, or health outcomes research training
Board Certified Pharmacotherapy Specialist
Six Sigma, Lean (or other quality program) background
Registered pharmacist; Degree of Doctor of Pharmacy
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, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.Application Deadline: 04-29-2026
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.