Pharmacist, Population Health

Navitus; Sacramento (CA); Remote; USD 110,000 - 160,000; Full time

Benefits offered by this job

Health, Dental, Vision insurance

20 days paid time off

4 weeks paid parental leave

9 paid holidays

401K company match up to 5%

Adoption Assistance Program

Flexible Spending Account

Educational Assistance Plan and Pro M’

Job summary

Navitus Health Solutions is seeking a Pharmacist, Population Health to join our team. The Pharmacist will support clinical programs including Drug Utilization Review and Health Management across lines of business, ensuring clinically sound, cost-effective programs.

You will review outcomes data, develop evidence-based documentation, and collaborate with Account Management, Lumicera, and P&T committees to implement programs and translate guidelines into actionable workflows.

Qualifications

• Bachelor's degree in Pharmacy or PharmD required.
• Current, unrestricted pharmacist license in state of residence or ability to reciprocity within 4 months.
• 2+ years of clinical experience or residency with 1 year clinical experience.
• Knowledge of PBM industry, formulary management and managed care principles.
• Proficiency in drug literature and clinical trial evaluation; familiarity with online databases.
• Proficiency in MS Word, Excel, PowerPoint (tables, charts, figures).
• Commitment to compliance program objectives.
• Ability to interact cooperatively and respectfully with colleagues.

Responsibilities

• Lead development of new clinical programs and maintain existing programs.
• Educate and inform clients, members, providers, and staff on clinical programs and outcomes.
• Provide clinical outreach to members, prescribers, and pharmacy providers.
• Support operations in implementing PBM programs and daily member care.
• Concisely communicate Medicare Part D, PQA, and HEDIS guidelines to stakeholders.
• Assist Residency Program Director with the PGY1 Managed Care Residency.
• Provide leadership and direction to Product Managers.
• Engage with Specialty Clinical Group for expert input.
• Participate in Coverage Determination process when needed.
• Provide clinical input on formulary decisions by the P&T Committee.
• Fulfill other duties as assigned.

Skills

Pharmacist license

Clinical experience

PBM knowledge

Drug literature

MS Office

Compliance

Teamwork

Education

Pharmacy degree (PharmD)

Tools

Micromedex

Medline

Facts & Comparisons

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.