[Hiring] Pharmacist, Population Health @Navitus Health Solutions

Role Description

Navitus Health Solutions is seeking a Pharmacist, Population Health to join our team! The Pharmacist, Population Health will be responsible for:

• 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.
• Providing support to other clinical areas including Account Management, Lumicera, Drug Information and Pipeline, and the Pharmacy and Therapeutics (P&T) Committee.
• Reviewing, evaluating, and sharing health outcomes and utilization data for program management and development.
• Developing and maintaining appropriate clinical, evidence-based documentation that supports PBM programs.
• Ensuring that Navitus can provide clinically sound programs (including products, edits, and reports) in the most cost-effective manner.
• Utilizing technology to implement clinical programs, which involves translation between technical guidelines and clinical program business requirements as well as program testing.

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.

Requirements

• 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.
• Have strong knowledge of various standards, regulations, and guidance including Medicare Part D, PQA, and HEDIS measures.
• 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.

Benefits

• 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!