Pharmacist, Population Health

Navitus Health Solutions, LLC•,

1d•$101,335 - $126,669•Remote

About The Position

Navitus Health Solutions is seeking a Pharmacist, Population Health to join our team! The Pharmacist, Population Health will be responsible to perform duties related to the 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. The Pharmacist, Population Health will also provide support to other clinical areas including Account Management, Lumicera, Drug Information and Pipeline, and the Pharmacy and Therapeutics (P&T) Committee. Additionally, the Pharmacist, Population Health is responsible for reviewing, evaluating, and sharing the health outcomes and utilization data for program management and development. The Pharmacist, Population Health will develop and maintain appropriate clinical, evidence-based documentation that supports PBM programs. The primary functions involve ensuring that Navitus can provide clinically sound programs (including products, edits, and reports) in the most cost-effective manner and utilize technology to implement clinical programs. This utilization of technology frequently involves translation between technical guidelines and clinical program business requirements as well as program testing.

Requirements

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.
Participate in, adhere to, and support compliance program objectives
The ability to consistently interact cooperatively and respectfully with other employees

Nice To Haves

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

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