Remote Telehealth Pharmacist - MTM & Medicare Specialist

Navitus; Denver (CO); Remote; USD 110,000 - 140,000; Full time

Benefits offered by this job

Health, dental, and 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/​f

Referral Bonus Program - up to $750

Job summary

Navitus Health Solutions is expanding its Telehealth Pharmacist team in Denver to deliver Medication Therapy Management (MTM) services for commercial and Medicare members via our Clinical Engagement Center (CEC). The role includes developing MTM programs and supporting outreach to improve patient health and client outcomes.

The ideal candidate holds an active pharmacist license, with 2+ years of clinical MTM experience and strong knowledge of CMS guidelines, HIPAA, and Part D regulations.

Qualifications

• Active pharmacist license in the state of residence or ability to obtain reciprocity within 4 months.
• Minimum of two years of clinical MTM or similar direct consultation experience.
• Experience as a clinical call center lead is preferred.
• Experience in multi-disciplinary teams and healthcare regulations is preferred.
• Knowledge of HIPAA and data privacy practices.
• Spanish-speaking is preferred.

Responsibilities

• Conduct MTM and expanded clinical programs in accordance with CMS.
• Develop clinical algorithms, pathways, and call scripts for MTM delivery.
• Review and update algorithms and scripts at least yearly with updated guidelines.
• Develop documentation standards for all clinical outreach.
• Collaborate with CEC staff to maintain a high-quality MTM product.
• Assist leadership to develop programs supporting STAR ratings outreach.
• Provide Medicare Part D clinical, operational and educational support and stay current on regulations.
• Serve as a preceptor for APPE students within the CEC department.
• Adhere to compliance and HIPAA regulations.
• Other duties as assigned.

Skills

Clinical MTM experience

Call center leadership

Medicare Part D knowledge

HIPAA/privacy knowledge

Spanish language skills

PBM industry experience

Job description

Navitus Health Solutions is expanding its Telehealth Pharmacist team in Denver to deliver Medication Therapy Management (MTM) services for commercial and Medicare members via our Clinical Engagement Center (CEC). The role includes developing MTM programs and supporting outreach to improve patient health and client outcomes.

The ideal candidate holds an active pharmacist license, with 2+ years of clinical MTM experience and strong knowledge of CMS guidelines, HIPAA, and Part D regulations.