Supervisor, Pharmacy Quality

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🔥 14 minutes ago

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Logo of Navitus Health Solutions

Navitus Health Solutions

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 the effectiveness of the Specialty Pharmacy Quality Management Program • Identify, assign, and supervise the work of quality analysts • Monitor the performance of the Quality team and individual analysts and make improvements where necessary • Oversee evaluations performed by analysts and collaborate to create improvement plans for agents • Create project plans for improvements and see them through to resolution • Produce reports supporting improvements and outcome-based evaluations after improvements occur • Recommend specialty pharmacy quality metrics, benchmarks, action plans, and supporting data analysis • Request, review, and assess quality monitoring data routinely • Monitor internal and external customer insights to evaluate quality analysts and pharmacy personnel • Track, trend, and analyze escalations and data outliers for root cause and improvement • Maintain a robust calibration process ensuring consistency across the Quality Management Program • Facilitate improvements, including writing business requirements and testing enhancements • Present current-state assessments and recommendations to leadership using data • Perform other duties as assigned

🎯 Requirements

• Minimum associate degree or at least 2 years relevant experience • Supervisory experience or experience as a quality analyst • Experience using data to make assessments /derive recommendations to impact change • Experience developing and executing on improvements • Demonstrated excellence in a customer service role • Participate in, adhere to, and support compliance program objectives • The ability to consistently interact cooperatively and respectfully with other employees • Residents of Arizona, Alabama, Arkansas, California, Colorado, Florida, Georgia, Illinois, Indiana, Iowa, Louisiana, Maryland, Michigan, Minnesota, Missouri, Nebraska, Nevada, New Jersey, New York, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, Tennessee, Texas, Utah, Virginia, Washington, or Wisconsin • M-F 8am to 5pm CST

🏖️ 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): 10.00

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