Pharmacist, Population Health

Navitus Health Solutions, LLC•,

7d•$101,335 - $126,669•Remote

About The Position

Navitus Health Solutions is seeking a Pharmacist, Population Health to develop, implement, report on outcomes, administer, and support clinical programs across all lines of business. Programs include Drug Utilization Review, Health Management initiatives such as clinical edits, asthma and COPD management, pharmacogenomics, medication adherence, prescriber insights, and MTM, as well as strategic initiatives such as the Residency Program. The role also supports Account Management, Lumicera, Drug Information and Pipeline, and the Pharmacy and Therapeutics Committee. The Pharmacist reviews, evaluates, and shares health outcomes and utilization data to support program management and development, and develops and maintains evidence-based clinical documentation for PBM programs. The role helps ensure programs, products, edits, and reports are clinically sound and cost-effective, and uses technology to implement programs, including translating technical guidelines into business requirements and testing programs. The position is remote and is available only to residents of the states and jurisdictions listed in the posting. The stated schedule is Monday through Friday, 8 a.m. to 5 p.m.

Requirements

Bachelor’s degree in Pharmacy or PharmD.
Current, unrestricted Registered Pharmacist licensure in the state of residence, or ability to gain reciprocity within four months.
At least two years of clinical experience, or completion of a clinical or managed care pharmacy practice residency and one year of clinical experience.
Participate in, adhere to, and support compliance program objectives.
Consistently interact cooperatively and respectfully with other employees.

Nice To Haves

Knowledge of the PBM industry, formulary management, pharmacy claims, and managed care principles and practices.
Proficiency in drug literature and clinical trial evaluation, including use of electronic databases such as Micromedex, Medline, and Facts & Comparisons.
Proficiency in Microsoft Word, Excel, and PowerPoint, including tables, charts, and figures.

Responsibilities

Lead the development of new clinical programs and manage maintenance of existing programs.
Facilitate communication and education for clients, members, providers, and internal staff about clinical programs and their outcomes.
Provide clinical outreach to members, prescribers, and pharmacy providers to enhance care coordination.
Support operational departments with implementation and daily operation of PBM programs to support member and patient quality of care, collaborating across departments to develop, implement, and maintain clinical programs.
Apply and communicate knowledge of standards, regulations, and guidance, including Medicare Part D, PQA, and HEDIS measures, to stakeholders and clients.
Assist the Residency Program Director 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 process, including certification, prior authorization, medical exception, and exception to coverage, when needed.
Provide clinical expertise related to formulary decisions made by the P&T Committee and Formulary Advisory Committee.
Review, evaluate, and share health outcomes and utilization data for program management and development.
Develop and maintain appropriate clinical, evidence-based documentation supporting PBM programs.
Translate technical guidelines into clinical program business requirements and support program testing.
Perform other duties as assigned.