Pharmacist, Population Health

Navitus Health Solutions, LLC; El Paso (TX); Remote; USD 101,000 - 127,000; Full time

Benefits offered by this job

Health insurance

Paid time off (PTO)

Parental leave—4 weeks

Paid holidays (9)

401K company match (up to 5%)

Adoption Assistance

Flexible Spending Account

Educational Assistance & ProfessionalD

Referral Bonus Program

Job summary

Navitus Health Solutions is seeking a Pharmacist, Population Health to join our team. The Pharmacist will develop, implement, and evaluate clinical programs including Drug Utilization Review, health management programs, and MTM across lines of business.

The role requires translating clinical guidelines into cost-effective PBM initiatives and collaborating across departments. The position supports Residency initiatives and interacts with Account Management, Lumicera, and the P&T Committee.

Qualifications

• Bachelor’s degree in Pharmacy or PharmD is required.
• Active pharmacist license in the state of residence or reciprocity within 4 months.
• 2+ years of clinical or managed care experience, or residency plus 1 year clinical experience.
• Knowledge of PBM industry, formulary management, and pharmacy claims preferred.
• Familiarity with medical literature and clinical trial evaluation; preferred databases include Micromedex, Medline, Facts & Comparisons.
• Proficiency in MS Word, Excel and PowerPoint.
• Participate in compliance program objectives.
• Ability to interact cooperatively with colleagues.

Responsibilities

• Lead development of new clinical programs and maintain existing ones.
• Facilitate communication about clinical programs and outcomes to clients, members, providers, and staff.
• Provide clinical outreach to members and prescribers to improve care coordination.
• Support PBM program implementation and daily operations across departments.
• Communicate regulatory guidance (Medicare Part D, PQA, HEDIS) clearly to stakeholders.
• Assist Residency Program Director with the PGY1 Managed Care Residency Program.
• Provide leadership to Product Managers and contribute to project direction.
• Engage with the Specialty Clinical Group and participate in coverage determination processes.
• Support formulary decisions made by the P&T and Formulary Advisory Committees.

Skills

2+ years clinical experience

Residency program (PGY1)

Education

Bachelor’s degree in Pharmacy

PharmD

Tools

MS Word

Excel

PowerPoint

Job description

Company Navitus

About Us Navitus - Putting People First in Pharmacy - Navitus was founded as an alternative to traditional pharmacy benefit manager (PBM) models. We are committed to removing cost from the drug supply chain to make medications more affordable for the people who need them. At Navitus, our team members work in an environment that celebrates diversity, fosters creativity and encourages growth. We welcome new ideas and share a passion for excellent service to our customers and each other.

Current associates must use SSO login option at to be considered for internal opportunities.

We are committed to providing equal employment opportunity to all applicants and employees and comply with all applicable nondiscrimination regulations, including those related to protected veterans and individuals with disabilities. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, or handicap.

Pay Range USD $101,335.35 - USD $126,669.19 /Yr.

STAR Bonus % (At Risk Maximum) 10.00 - Pharm, Supvr, AsMgr, SrCSEII, PrgMgr, SrPrgMgr, SrProdMgr

Work Schedule Description (e.g. M-F 8am to 5pm) M-F 8am to 5pm

Remote Work Notification ATTENTION: Navitus is only able to offer remote work to residents of Alabama, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Florida, Georgia, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Montana, Nebraska, Nevada, New Jersey, New York, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, Tennessee, Texas, Utah, Vermont, Virginia, Washington, Washington DC, Wisconsin.

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.

Responsibilities

• 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

• 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!

Location

Location : Address Remote

Location : Country US