Manager, Government Clinical Services

Job not on LinkedIn

November 3

🧀 Wisconsin – Remote

Although this job is listed in Wisconsin, this company may be open to hiring remote in other states.

💵 $120k - $150k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

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Navitus Health Solutions

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Healthcare Insurance • Pharmaceuticals • B2B

Navitus Health Solutions is a pharmacy benefit manager (PBM) that provides transparent, people-centered pharmacy benefit solutions to health plans, employers, government programs and other plan sponsors. The company operates a 100% pass-through, cost-plus model that emphasizes lowering medication costs, managing formularies, specialty drug management (including a cost-plus specialty pharmacy), claims adjudication, pharmacy network management, and member enablement and support services. Navitus positions itself as a fiduciary partner focused on affordability, compliance, clinical quality and improving health outcomes through tailored PBM services and digital health integrations.

1001 - 5000 employees

Founded 2003

⚕️ Healthcare Insurance

💊 Pharmaceuticals

🤝 B2B

📋 Description

• Provide leadership, training, supervision, and strategic direction to department Pharmacists and Product Managers. • Assist with the fiscal management of the department, including forecasting, budget development, staffing, and trending of programs, in support of Navitus’ strategic and business initiatives. • Lead the development of new clinical programs and manage the maintenance and continuous improvement of existing programs to keep innovation and evidence-based programs a differentiator for Navitus. • Serve as a key stakeholder and decision-maker on implementation of new Medicaid and Medicare clinical requirements. • Have strong knowledge of current standards, regulations, and guidance including CMS, PQA, and HEDIS measures and have the ability to concisely communicate that information to stakeholders and clients. • Assist Customer Care, Customer Success, and other internal customers in responding to and resolving pharmacy-related inquiries from Medicaid and Medicare members, clients, providers, or pharmacies. • Assist the Residency Program Director with the accredited PGY1 Managed Care Residency Program. • Assist the Customer Success, Implementation, and Government Programs teams with new Medicaid and Medicare implementations and with annual re-implementations, including support of the transition process to ensure clinical and operational functionality. • Other duties as assigned.

🎯 Requirements

• Bachelor’s degree in pharmacy or Pharm D required. • 5 years clinical experience, or clinical/managed care pharmacy practice residency plus three years clinical experience required. • Knowledge of PBM industry, formulary management, clinical outcomes research, pharmacy claims, and managed care principles and practices desired. • Participate in, adhere to, and support compliance program objectives • The ability to consistently interact cooperatively and respectfully with other employees.

🏖️ Benefits

• Top of the industry benefits for Health, Dental, and Vision insurance • 20 days paid time off • 4 weeks paid parental leave • 9 paid holidays • 401K company match of up to 5% - No vesting requirement • Adoption Assistance Program • Flexible Spending Account • Educational Assistance Plan and Professional Membership assistance • Referral Bonus Program – up to $750!