Remote Pharmacist, Population Health & Clinical Programs

Navitus; Richmond (VA); Remote; USD 110,000 - 140,000; Full time

Benefits offered by this job

Health insurance

Paid time off

Parental leave

401K match

Adoption Assistance

Flexible Spending Account

Educational Assistance

Referral Bonus

Job summary

Navitus Health Solutions is seeking a Pharmacist, Population Health to oversee development and administration of clinical programs, including RDUR, CDUR, and MTM, across all lines of business. You will translate clinical guidelines into cost-effective program edits, reports, and workflows.

You will review health outcomes data, support the P&T Committee, and collaborate with Account Management, Lumicera, and other clinical groups to advance program success.

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

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

Skills

Clinical pharmacy

PBM knowledge

Regulatory compliance

Stakeholder communication

Data interpretation

Education

Bachelor’s degree in Pharmacy

PharmD

Tools

Micromedex

Medline

Facts & Comparisons

MS Word

MS Excel

MS PowerPoint

Job description

Navitus Health Solutions is seeking a Pharmacist, Population Health to oversee development and administration of clinical programs, including RDUR, CDUR, and MTM, across all lines of business. You will translate clinical guidelines into cost-effective program edits, reports, and workflows.

You will review health outcomes data, support the P&T Committee, and collaborate with Account Management, Lumicera, and other clinical groups to advance program success.