
1001 - 5000 employees
Founded 2003
💼 Consulting
🛡️ Insurance
🏥 Healthcare
Consulting • Insurance • Healthcare
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.
🔥 0 minutes ago
🗣️🇪🇸 Spanish Required
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1001 - 5000 employees
Founded 2003
💼 Consulting
🛡️ Insurance
🏥 Healthcare
Consulting • Insurance • Healthcare
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.
• Place outbound phone calls to members to offer Medication Therapy Management (MTM) services and other commercial programs outside of traditional MTM • Provide outreach to members, prescribers, and pharmacy providers to enhance care coordination and support the Star ratings program • Field inbound phone calls from members to initiate MTM or other CEC services • Conduct telephonic comprehensive medication interviews and document medications as part of the MTM Program • Facilitate communication to clients, providers, and internal staff regarding CEC programs and program outcomes • Maintain knowledge of regulations regarding CEC programs • Develop a full understanding of Navitus Clients’ member experience and how the CEC contributes to improved health and wellness • Comply with all applicable HIPAA and CMS regulations • Perform other duties as assigned
• High school diploma or GED • Previous experience as a Pharmacy Technician • Valid Pharmacy technician license/certification as required by state laws • Active national pharmacy technician certification through either PTCB or NHA is strongly preferred • Fluency in both English and Spanish is strongly preferred • Experience as a member of a multi-disciplinary team is preferred • Knowledge of applicable data privacy practices and laws is preferred • Knowledge of healthcare industry practices and HIPAA regulations • Participate in, adhere to, and support compliance program objectives • Ability to consistently interact cooperatively and respectfully with other employees • Compliance with applicable HIPAA and CMS regulations • Ability to work the stated schedule: M-Th, 8:30am-7pm and Friday 8:30am-5pm • Remote work is unavailable to residents of Alaska, Hawaii, Maine, Mississippi, New Hampshire, New Mexico, North Dakota, Rhode Island, South Carolina, South Dakota, West Virginia, and Wyoming
• 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!
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