Clinical Policy Operations Professional 2

Humana · Santa Fe, NM, United States

Location
Santa Fe
Job Type
Full-time
Posted
July 13, 2026

Job Description

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The Clinical Policy Operations Professional 2 provides operational support to clinical pharmacists for the implementation, maintenance, submission, and ongoing management of clinical policies, drug lists, and benefit requirements. This role focuses on accurately translating approved clinical strategies into operational systems and tools, requiring strong attention to detail, independent problem solving, and consistent execution within established processes.
The Clinical Policy Operations Professional 2 ensures accuracy and compliance for utilization management (UM) criteria within the Clinical Policy System, operational guidance documentation, and the submission and maintenance of policies provided to external accreditation and review bodies. They collaborate with healthcare professionals, pharmacists, and business stakeholders to operationalize clinical policy strategies and perform quality analysis and reporting to ensure effective oper...

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