Pharmacist, Population Health

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $101.3k - $126.7k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

💊 Pharmacist

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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

• Lead the development of new clinical programs and manage the maintenance of existing programs. • Facilitate communication and education to clients, members, providers, and internal staff regarding clinical programs and program outcomes. • Provide clinical outreach to members, prescribers, and pharmacy providers to enhance care coordination. • Support operational departments with implementation and daily functioning of PBM programs to support member/patient quality of care. • Collaborate across departments and provide guidance to develop, implement, and maintain clinical programs. • Communicate standards, regulations, and guidance including Medicare Part D, PQA, and HEDIS measures to stakeholders and clients. • Assist the Residency Program Director with the PGY1 Managed Care Residency Program. • Provide leadership, training, supervision, and strategic direction to Product Managers. • Provide expertise through active involvement with the Specialty Clinical Group. • Participate in the Coverage Determination process when needed. • Provide clinical expertise related to formulary decisions made by the P&T Committee and Formulary Advisory Committee. • Review, evaluate, and share health outcomes and utilization data for program management and development. • Develop and maintain clinical, evidence-based documentation supporting PBM programs. • Translate technical guidelines into clinical program business requirements and support program testing. • Perform other duties as assigned.

🎯 Requirements

• Bachelor’s degree in Pharmacy or PharmD required. • Current, unrestricted licensure as a Registered Pharmacist in the state of residence, or the ability to gain reciprocity within 4 months. • 2+ years of clinical experience, or clinical or managed care pharmacy practice residency and 1-year clinical experience. • Knowledge of PBM industry, formulary management, pharmacy claims and managed care principles and practices desired. • Proficiency in drug literature and clinical trial evaluation, including proficiency with electronic databases (e.g., Micromedex, Medline, Facts & Comparisons) preferred. • Proficiency in MS Word, Excel, PowerPoint including tables, charts and figures preferred. • 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!