Specialist, Clinical Engagement (CPhT)

Navitus; Richmond (VA); Remote; USD 60,000 - 80,000; Full time

Benefits offered by this job

Health insurance

Paid time off

Parental leave

Paid holidays

401K company match

Adoption Assistance Program

Flexible Spending Account

Educational Assistance Plan

Referral Bonus Program - up to $750

Job summary

Navitus Health Solutions is seeking a Specialist, Clinical Engagement to join our team. The role focuses on MTM, Stars Adherence, and proactive outreach to improve medication adherence and patient engagement by delivering high-quality clinical services via telephonic consultations.

The Specialist reports to the Supervisor, CEC Operations and collaborates with cross-functional teams to ensure timely access to medications and resources while maintaining compliance with HIPAA and program guidelines.

Qualifications

• High School diploma or GED required.
• Certified Pharmacy Technician certification required.
• State license required where applicable.
• 3 years pharmacy support or clinical program execution experience.
• Strong pharmaceutical knowledge for safe, informed outcomes.
• Demonstrated empathetic, patient-focused communication.
• Experience following workflows, scripts and escalation protocols.
• Knowledge of HIPAA regulations and compliance standards.
• Ability to collaborate in cross-functional teams to meet goals.
• Participate in and support compliance program objectives.
• Professional conduct with cooperative and respectful interactions.

Responsibilities

• Independently conduct MTM and Stars Adherence initiatives to support quality and outcomes.
• Proactively reach out to patients to improve engagement and program participation.
• Coordinate patient care to ensure timely access to medications and therapy continuity.
• Educate patients on program benefits and medication adherence with professional judgment.
• Facilitate prescription renewals and extended day supply requests with pharmacies or providers.
• Identify barriers to access and connect members with clinical or operational resources.
• Apply sound professional judgment and escalate non-routine decisions when needed.
• Adhere to protocols and regulatory requirements in daily workflows.
• Support department performance by completing assigned tasks accurately.
• Collaborate with CEC teammates to ensure consistent high-quality services.
• Other duties as assigned.

Skills

Empathetic communication

Cross-functional collaboration

HIPAA knowledge

Time management

Education

High School diploma or GED

Certified Pharmacy Technician

State Pharmacy Technician license

Job description

Overview

Navitus Health Solutions is seeking a Specialist, Clinical Engagement to join our team!

The Specialist, Clinical Engagement serves as a key member of the Clinical Engagement Center (CEC) team, responsible for delivering high-quality clinical engagement through telephonic medication consultations, health education, and care coordination. This position plays a critical role in advancing medication adherence and patient engagement strategies by execution of Medication Therapy Management (MTM), Stars Adherence, and ongoing clinical initiatives, within defined program guidelines. The Specialist will report to the Supervisor, CEC Operations, as well as interact with other CEC Operations leaders.

As part of the CEC, the Specialist, Clinical Engagement supports Navitus' commitment to delivering high-quality, patient-centered care through proactive outreach, problem-solving, and coordination with internal and external stakeholders. This position helps ensure that patients receive timely access to medications and resources, ultimately contributing to improved clinical performance aligning with Navitus' strategic goals for health and wellness.

Is this you? Find out more below!

Responsibilities

How do I make an impact on my team?

• Independently conduct, within established protocols, Medication Therapy Management (MTM) and Stars Adherence initiatives to support organizational quality, performance, and patient outcomes.
• Conduct proactive patient outreach using advanced communication techniques to improve engagement, adherence, and program participation.
• Coordinate patient care activities to ensure timely access to medications and continuity of therapy, prioritizing work and resolving routine issues with minimal supervision.
• Collaborate with CEC team members to support consistent, high quality clinical services and shared accountability for outcomes.
• Educate patients on program benefits and medication adherence, applying professional judgment within program protocols to identify risks, address barriers, and determine appropriate interventions.
• Facilitate prescription renewals and extended day supply requests, managing exceptions and coordinating with pharmacies or providers as needed.
• Identify and address barriers to medication access by assessing patient specific challenges and connecting members with appropriate clinical or operational resources.
• Ability to apply sound professional judgment in well-defined situations and appropriately elevate when additional guidance is needed.
• Adhere to established protocols and regulatory requirements, escalating non-routine decisions involving complex, sensitive, or high-risk situations appropriately.
• Support operational effectiveness by completing assigned workflows accurately and efficiently and taking ownership of tasks that contribute to overall department performance.
• Other duties as assigned.

Qualifications

What our team expect from you?

• High School diploma or GED required.
• Certified Pharmacy Technician certification required. State Pharmacy Technician license required where applicable.
• 3 years of pharmacy support experience or clinical program execution required.
• Strong pharmaceutical knowledge to accurately address inquiries, support medication-related processes, and ensure safe, informed outcomes required.
• Demonstrated ability to deliver empathetic, patient-focused support by actively listening, addressing needs, and ensuring clear, respectful communication across diverse populations required.
• Demonstrated experience effectively managing inbound and outbound communications while consistently following established workflows, scripts, and escalation protocols to ensure quality and efficiency required.
• Knowledge of healthcare regulations, including HIPAA, that protects patient information and ensures all interactions and documentation meet compliance standards required.
• Demonstrated ability to collaborate within cross-functional teams to meet service level expectations, support shared goals, and contribute to overall operational success required.
• 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.

Equal employment opportunity, including veterans and individuals with disabilities.