The Pharmacy Claims Lead – Financial Recovery leads a team that is responsible for monitoring pharmacy outstanding balances, determining which cases require direct outreach to the pharmacies, and negotiating financial recoveries.
Analyzes large sets of data and produces various reports and summaries for decision making purposes.
Advises executives to develop functional strategies (often segment specific) on matters of significance.
Exercises independent judgment and decision making on complex issues regarding job duties and related tasks and works under minimal supervision.
Uses independent judgment requiring analysis of variable factors and determining the best course of action.
Required Qualifications
Bachelor's degree
5 or more years of technical experience including analyzing large sets and producing various reports and summaries
2 or more years of project leadership experience
Strong verbal and written communication skills, including the ability to tailor communication to audience
Ability to handle multiple tasks, meet deadlines, and follow-up timely
Comprehensive knowledge of all Microsoft Office applications, including Access, Word, Excel and PowerPoint
Must be passionate about contributing to an organization focused on continuously improving consumer experiences
Preferred Qualifications
Previous experience with pharmacy benefits management
Claims experience
Knowledge/experience working with SQL (via MS SQL Server, Oracle, PL/SQL or other)
Additional Information
Work at Home Guidance
To ensure Home or Hybrid Home/Office associates’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria:
#LI-PH1
Social Security Task:
Alert: Humana values personal identity protection. Please be aware that applicants being considered for an interview will be asked to provide a social security number, if it is not already on file. When required, an email will be sent from with instructions to add the information into the application at Humana’s secure website.
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.
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 because he or she is a protected veteran. It is also the policy of Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, 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.
Share this job with your friends
Copyright © 2024 Grabjobs Pte.Ltd. All Rights Reserved.