Pharmacist, Population Health

Navitus Health Solutions, LLC

United States

Remote

USD 101,000 - 127,000

Full time

14 days+

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Benefits offered by this job

Health, Dental & Vision insurance

20 days PTO

4 weeks parental leave

9 paid holidays

401K 5% match

Adoption Assistance

FSA

Educational & Membership assistance

Referral Bonus up to $750

Job summary

Navitus Health Solutions is seeking a Pharmacist, Population Health to join our team. You will develop, implement, and monitor clinical programs including RDUR/CDUR, MTM, and asthma/COPD management across lines of business.

You will translate clinical guidelines into practical program requirements and generate outcomes data. The role collaborates with Account Management, Lumicera, and P&T committees, providing leadership for residency programs and guidance to product managers.

Qualifications

Bachelor’s degree in Pharmacy or PharmD required.
Active pharmacist license in resident state or reciprocity within 4 months.
2+ years of clinical or managed care pharmacy experience or residency with 1-year clinical experience.
Knowledge of PBM industry, formulary management and pharmacy claims.
Proficiency with drug literature and clinical trial evaluation; electronic databases preferred.
MS Word, Excel, PowerPoint proficiency.

Responsibilities

Lead the development of new clinical programs and maintain existing ones.
Educate clients, members, providers, and internal staff on program outcomes.
Provide clinical outreach to members, prescribers, and providers to enhance care coordination.
Support operations on PBM program implementation and daily functioning.
Communicate Medicare Part D, PQA, and HEDIS guidance to stakeholders.
Assist Residency Program Director with PGY1 Managed Care Residency Program.
Provide leadership and direction to Product Managers.
Offer expertise through the Specialty Clinical Group involvement.
Participate in Coverage Determination processes as needed.
Advise on formulary decisions with P&T committees.

Skills

Pharmacist licensure

Clinical pharmacy

Residency/clinical experience

Education

Bachelor’s degree in Pharmacy

PharmD

Tools

Micromedex

Medline

Facts & Comparisons

MS Office

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 https://employees-navitus.icims.com/ 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.

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?