Senior Manager, Specialty Client Support

Job not on LinkedIn

🔥 0 minutes ago

🐻 Alaska, Hawaii, +11 more states – Remote

🐻 Alaska – Remote 🌺 Hawaii – Remote 🦞 Maine – Remote 🗻 New Hampshire – Remote 🌶️ New Mexico – Remote 🌾 North Dakota – Remote 🎸 Mississippi – Remote ⚓ Rhode Island – Remote 🌴 South Carolina – Remote 🗿 South Dakota – Remote ⚔️ Virginia – Remote ⛰️ West Virginia – Remote 🦬 Wyoming – Remote

💵 $124.1k - $155.2k / year

⏰ Full Time

🟠 Senior

📁 Client Services

👻 Ghost score 0%

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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

• Serve as a specialty pharmacy subject matter expert, translating specialty pharmacy, limited distribution drug, REMS, site-of-care, access, reimbursement, and network concepts into actionable recommendations • Participate in client meetings, quarterly business reviews, RFP support, and presentations as the specialty provider network expert • Advise on specialty network initiatives supporting client goals, lowest-net-cost opportunities, member access, and organizational strategy • Oversee specialty client support processes, procedures, and service standards • Lead resolution of specialty pharmacy escalations involving network access, reimbursement, formulary, contract, and member issues • Manage specialty pharmacy client initiatives from ideation through implementation and ongoing enhancement • Develop and maintain project plans, policies, procedures, work instructions, and scalable workflows • Support ongoing management of specialty pharmacy contracts • Evaluate reimbursement pricing structures, network performance, vendor capabilities, market competitiveness, and industry developments • Collaborate with internal teams and external partners to expand network partnerships and enhance pharmacy services • Ensure initiatives and implementation processes meet corporate, compliance, Medicare, Medicaid, commercial, exchange, and state regulatory requirements • Manage specialty client support staff, including hiring, performance, workload prioritization, and professional development • Execute departmental strategic initiatives and continuous improvement efforts • Participate in and support compliance, people and culture, and learning programs • Perform other duties as assigned

🎯 Requirements

• PharmD degree or Bachelor’s degree from an accredited College of Pharmacy required • Current, unrestricted licensure as a Registered Pharmacist in the state of residence, or the ability to gain reciprocity within 4 months, may be required based on state of residence laws or client contracts • 4+ years as a licensed Pharmacist required • 3+ years’ experience in leading and mentoring staff required • 1+ year of PBM or Managed Care experience preferred • Experience of specialty pharmacy drugs including REMS and Limited Distribution Products best practices required • Prior experience with managing vendors or accounts preferred • Product management/development or related experience preferred • Clinical experience in specialty pharmacy strongly preferred • Experience in the health, biomedical or pharmaceutical fields preferred • Experience with CMS, Medicare, and state Medicaid regulations and guidance preferred • Combination of training, education, and experience equivalent to the employment standard may qualify

🏖️ 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): 12.50