Consultant, Pharmacy Network

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Navitus Health Solutions

WebsiteLinkedInAll Job Openings

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.

📋 Description

• Manage strategic client relationships for assigned pharmacy network management clients, including retail and specialty lines of business • Build and maintain strong client relationships and act as a point of contact for client inquiries and issues • Oversee and improve client support processes and procedures, ensuring timely and accurate responses regarding provider services • Track key performance related to client pharmacy network management support and analyze data to identify improvement areas • Lead Navitus client inquiries and act as Subject Matter Expert regarding client deliverables and open items • Monitor standards and metrics to drive performance and exceed client service quality expectations • Interpret claims utilization and data from data warehouses, NCRx, formulary files, pharmacy network databases, NCPDP pharmacy files, Medispan files, and other databases • Maintain and manage projects that improve existing processes and deliver enhanced quality and efficiency • Support clients and other Navitus departments in new client implementations and participate in client-facing meetings • Support the Provider Services team in client retention, corporate strategic goals, and customer satisfaction • Manage client inquiries regarding contractual issues, pharmacy participation, pharmacy services, and network discounts • Perform other duties as assigned

🎯 Requirements

• Bachelor’s degree in healthcare administration, business management, pharmacy, or related field, or equivalent work experience, required • Pharmacy technician certification preferred • 5+ years of business experience in PBM implementation, client management, or project management required • Strong understanding of PBM processes, pharmacy benefits, and healthcare industry regulations required • 3 years of experience in business, finance or economics preferred • Ability to participate in, adhere to, and support compliance program objectives • Ability to consistently interact cooperatively and respectfully with other employees • 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

🏖️ 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! • STAR Bonus % (At Risk Maximum) 5.00