Pharmacist, Population Health

Navitus; Oklahoma City (OK); Vor Ort; USD 110.000 - 140.000; Vollzeit

Benefits dieser Stelle

Health insurance

Dental insurance

Vision insurance

Paid time off (20 days)

Parental leave (4 weeks)

401K matching up to 5%

Adoption assistance

Flexible Spending Account

Educational assistance

Referral bonus

Zusammenfassung

Navitus Health Solutions is seeking a Pharmacist, Population Health to join our team in a role focused on developing and administering clinical programs, reporting outcomes, and supporting PBM initiatives across lines of business.

The Pharmacist will translate clinical guidelines into program requirements, support the P&T Committee, and collaborate with Account Management, Lumicera, and other clinical groups to improve member care and cost effectiveness.

Qualifikationen

• Bachelor’s degree in Pharmacy or PharmD is required.
• Current, unrestricted pharmacist licensure in the state of residence (or reciprocity within 4 months).
• 2+ years of clinical experience or residency with 1-year clinical experience.

Aufgaben

• Lead development of new clinical programs and maintain existing ones.
• Educate clients, members, providers, and staff on clinical programs and outcomes.
• Provide clinical outreach to members and prescribers to enhance care coordination.
• Support operational departments implementing PBM programs and daily member care.
• Communicate Medicare Part D, PQA, and HEDIS requirements to stakeholders.
• Assist Residency Program Director with the PGY1 Managed Care Residency.

Kenntnisse

Clinical experience

PBM knowledge

Pharmacy licensure

MS Office proficiency

Ausbildung

Bachelor's degree in Pharmacy or PharmD

Tools

Micromedex

Medline

Facts & Comparisons

MS Word

Excel

PowerPoint

Jobbeschreibung

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

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!

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.