Pharmacist, Population Health

Navitus; Carson City (NV); Remote; USD 110,000 - 165,000; Full time

Job summary

Navitus Health Solutions is seeking a Pharmacist, Population Health to develop and implement clinical programs, review outcomes, and support strategic PBM initiatives across lines of business.

The role requires a PharmD or equivalent, unrestricted licensure, and 2+ years of clinical or managed care experience, with strong knowledge of PBM, formulary management, and clinical data analysis.

Qualifications

• Current, unrestricted Pharmacist license in the state of residence or ability to gain reciprocity within 4 months.
• 2+ years of clinical experience, or residency plus 1 year of clinical experience.
• Knowledge of PBM industry, formulary management, and managed care principles.
• Proficiency with drug literature and clinical trial evaluation; experience with online databases.
• MS Word, Excel, PowerPoint proficiency.
• Commitment to compliance program objectives and respectful collaboration.

Responsibilities

• Lead development and maintenance of Navitus clinical programs and related PBM initiatives.
• Provide outreach to clients, members, prescribers, and providers to share outcomes.
• Support operational departments in implementing PBM programs and daily operations.
• Contribute to guidelines for Medicare Part D, PQA, and HEDIS measures; communicate implications.
• Assist Residency Program Director with PGY1 Managed Care Residency Program.
• Provide leadership to Product Managers and collaborate with Specialty Clinical Group.
• Participate in Coverage Determination processes when needed.
• Support formulary decisions with P&T Committee input.

Skills

Clinical experience

PBM knowledge

Communication

Regulatory compliance

Team collaboration

Education

Bachelor’s degree in Pharmacy or PharmD

Tools

Micromedex

Medline

Facts & Comparisons

MS Word

MS Excel

PowerPoint

Job description

Overview

Navitus Health Solutions is seeking a Pharmacist, Population Health to join our team!

The Pharmacist, Population Health will be responsible to perform duties related to the development, implementation, outcomes reporting, and ongoing administration and support of Navitus Clinical Programs including Drug Utilization Review (i.e., RDUR, CDUR), Health Management (i.e., clinical edits, Asthma Management, COPD Management, Pharmacogenomics, Pharmacoadherence, Prescriber Insights, MTM), and other strategic clinical initiatives (i.e., Residency Program) across all lines of business. The Pharmacist, Population Health will also provide support to other clinical areas including Account Management, Lumicera, Drug Information and Pipeline, and the Pharmacy and Therapeutics (P&T) Committee.

Additionally, the Pharmacist, Population Health is responsible for reviewing, evaluating, and sharing the health outcomes and utilization data for program management and development. The Pharmacist, Population Health will develop and maintain appropriate clinical, evidence-based documentation that supports PBM programs. The primary functions involve ensuring that Navitus can provide clinically sound programs (including products, edits, and reports) in the most cost-effective manner and utilize technology to implement clinical programs. This utilization of technology frequently involves translation between technical guidelines and clinical program business requirements as well as program testing.

Is this you? Find out more below!

Responsibilities

How do I make an impact on my team?

• 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
• Provide support to operational departments on the implementation of various PBM programs and daily functioning in support of member/patient quality of care. This involves frequent interdepartmental collaboration and guidance to develop, implement, and maintain all clinical programs
• Have strong knowledge of various standards, regulations, and guidance including Medicare Part D, PQA, and HEDIS measures and concisely communicate that information to stakeholders and clients
• Assist Residency Program Director (RPD) 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 (Certification, Prior Authorization, Medical Exception, Exception to Coverage, etc.) process when needed
• Provide clinical expertise related to formulary decisions made by the P&T Committee and Formulary Advisory Committee
• Other duties as assigned

Qualifications

What our team expects from you?

• 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

What can you expect from Navitus?

• 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!

#LI-Remote

Navitus Health Solutions is an Equal Opportunity Employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, creed, sex, pregnancy, sexual orientation, gender identity or expression, national origin, age, disability, genetic information, veteran status, or any other characteristic protected by law.

Equal employment opportunity, including veterans and individuals with disabilities.

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