Returning Candidate? Log back in! Manager, Government Clinical Services Location US- ID 2024-3963 Category Administration Position Type Full-Time Remote Yes 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. Pay Range USD $120,524.00 - USD $150,655.00 /Yr. Work Schedule Description (e.g. M-F 8am to 5pm) M-F 8am to 5pm Overview

Navitus Health Solutions is seeking a Manager, Government Clinical Services to join our Clinical Program Management department! 

 

The Manager, Government Clinical Services provides strategic vision and operational oversight of the department as well as direct management and leadership of clinical staff within the department. The Manager ensures prompt program execution, presents products to external and internal clients, and drives results in support of the corporate strategic plan. The Manager will have responsibility for the required clinical services and for driving outcome analysis initiatives to completion. The Manager, in coordination with the Program Manager of Government Clinical Services, oversees duties related to the development, implementation, outcomes reporting, and ongoing administration of Navitus’ clinical programs, reports, and edits for Medicare and Medicaid populations while fostering a collaborative and cohesive team culture. Additionally, the Manager is responsible for the oversight and sharing of health outcomes, clinical measures, and utilization data used for program management and development.

 

Is this you? Find out more below!

Responsibilities

How do I make an impact on my team? 

Provide leadership, training, supervision, and strategic direction to department Pharmacists and Product ManagersAssist with the fiscal management of the department, including forecasting, budget development, staffing, and trending of programs, in support of Navitus’ strategic and business initiativesLead the development of new clinical programs and manage the maintenance and continuous improvement of existing programs to keep innovation and evidence-based programs a differentiator for NavitusLead discussions with clients, members, providers, vendors, and internal staff regarding Medicaid and Medicare clinical services and outcomesProvide clinical outreach to members, prescribers, and pharmacy providers to enhance care coordinationServe as a key stakeholder and decision-maker on implementation of new Medicaid and Medicare clinical requirementsHave strong knowledge of current standards, regulations, and guidance including CMS, PQA, and HEDIS measures and have the ability to concisely communicate that information to stakeholders and clientsAssist Customer Care, Customer Success, and other internal customers in responding to and resolving pharmacy-related inquiries from Medicaid and Medicare members, clients, providers, or pharmaciesAssist the Residency Program Director with the accredited PGY1 Managed Care Residency ProgramAssist the Customer Success, Implementation, and Government Programs teams with new Medicaid and Medicare implementations and with annual re-implementations, including support of the transition process to ensure clinical and operational functionalityOther duties as assigned Qualifications

What our team expects from you?

A minimum of a bachelor’s degree in pharmacy or Pharm DCurrent unrestricted licensure as an RPh in the State of Wisconsin or the ability to gain reciprocity within four months of employment is requiredMinimum five years clinical experience, or clinical/managed care pharmacy practice residency plus three years clinical experienceKnowledge of PBM industry, formulary management, clinical outcomes research, pharmacy claims, and managed care principles and practices desiredParticipate in, adhere to, and support compliance program objectivesThe 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! 

We are unable to offer remote work to residents of Alaska, Hawaii, Maine, Mississippi, New Hampshire, New Mexico, North Dakota, Rhode Island, South Carolina, South Dakota, West Virginia, and Wyoming.

 

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