- Apply clinical knowledge in the development of specialty pharmacy services and network contracting related to high-cost specialty drugs.
- Assist in the analysis of product capacity and capabilities for managing new clients.
- Serve as a specialty pharmacy expert to clients, vendors clinical teams, sales and marketing.
- Negotiate pharmacy network reimbursement ethically in support of Navitus' mission to meet or exceed clients' and Navitus' needs for all lines of business and programs, including Commercial, Medicare Part D, Managed Medicaid, Exchanges, and Narrow Retail, Specialty, and Mail Order Networks.
- Ongoing management of pharmacy network contracts, including timely renewals and updating of financial and legal terms in such contracts.
- Responsible for audits of the pharmacy contracts and any other related pharmacy performance guarantees and metrics.
- Assist in the determination of pharmacy network reimbursement pricing structures to align with organizational goals.
- Monitor market to expand network partnerships, drive enhancement and ensue quality network performance from specialty vendors.
- Guide specialty pharmacy product organization through process change strategies to provide for successful specialty pharmacy services for Navitus and Navitus clients.
- Oversee new client implementations for specialty pharmacy products and network contracting to ensure all client, and Navitus needs are successfully achieved.
- Licensed Pharmacist with Pharm D Degree or BS Degree from an accredited College of Pharmacy required. License must be current and unrestricted. Further pharmacy or disease certifications are helpful but not required. Possession of a valid Pharmacist license issued by the State where the pharmacy is domiciled and in all required State Board of Pharmacies necessary by the respective state to mail prescriptions into that state.
- Unrestricted licensure as a registered pharmacist by a states' board of pharmacy required.
- Minimum of three years as a licensed Pharmacist
- Minimum 1 - 3 years PBM or Managed Care experience is highly desired. Prior experience with managing vendors or accounts preferred.
- Product management/development or related experience is highly desired.
- Understanding of specialty pharmacy drugs including REMS and Limited Distribution Products best practices highly desired
- Clinical experience in specialty pharmacy is strongly preferred; or a combination of training, education, and experience that is equivalent to the employment standard listed above.
- Experience with CMS, Medicare, and state Medicaid regulations and guidance is preferred.
- Participate in, adhere to, and support compliance program objectives
- The ability to consistently interact cooperatively and respectfully with other employees
- Hours/Location: Monday-Friday 8:00am-5:00pm CST, Remote
- Paid Volunteer Hours
- Educational Assistance Plan and Professional Membership assistance
- Referral Bonus Program – up to $750
- Top of the industry benefits for Health, Dental, and Vision insurance, Flexible Spending Account, Paid Time Off, Nine paid holidays, 401K, Short-term and Long-term disability, College Savings Plan, Paid Parental Leave, Adoption Assistance Program, and Employee Assistance Program
-
Manager, Payer Contracting-Remote
2 weeks ago
Navitus Health Solutions LLC Madison, United StatesJob Description · Job DescriptionLumicera Health Services Powered by Navitus · Innovative Specialty Pharmacy Solutions- Lumicera Health Services is defining the "new norm" in specialty pharmacy to optimize patient well-being through our core principles of transparency and steward ...
-
Contract Manager for Gastronomy
3 weeks ago
NovaTech Solutions China, United StatesThe medium-sized Feldschlößchen AG is part of an owner-managed brewery group with locations in Germany and France. As a traditional Saxon company based in Dresden, we are exceptionally successful nationally and internationally. · Feldschlößchen stands for premium beers and mixed ...
-
External Contract Manufacturing Manager
2 weeks ago
Exact Sciences Corporation Madison, United States**Help us change lives** · At Exact Sciences, we're helping change how the world prevents, detects and guides treatment for cancer. We give patients and clinicians the clarity needed to make confident decisions when they matter most. Join our team to find a purpose-driven career, ...
-
Aurora Technologies Madison, United StatesMadison 'EnBW Energie Baden-Württemberg AG is currently seeking individuals who believe in the positive power of energy and their own strength to drive progress. We recognize the importance of energy and infrastructure and the potential they hold to shape a better future for all. ...
-
Navitus Health Solutions Madison, United StatesPutting 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 member ...
-
Manager, Privacy-Remote
3 weeks ago
Navitus Health Solutions Madison, United StatesPutting 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 member ...
-
Territory Manager-Remote
3 weeks ago
Priority1 Madison, United StatesPriority1 strives to go beyond simply offering jobs. We foster careers by creating a great working environment for our team members. We hire talented individuals who will provide the best support and can quickly adapt to the rapidly changing world of logistics. These talented men ...
-
Manager, Privacy-Remote
1 week ago
Navitus Health Solutions LLC Madison, United StatesJob Description · Job DescriptionPutting 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 ...
-
Manager, Information Technology-Remote
2 weeks ago
Navitus Health Solutions Madison, United StatesLumicera Health Services Powered by Navitus · Innovative Specialty Pharmacy Solutions- Lumicera Health Services is defining the "new norm" in specialty pharmacy to optimize patient well-being through our core principles of transparency and stewardship. Here at Lumicera, our team ...
-
Tax Manager- Fully Remote
1 week ago
Fine Point Consulting Madison, United StatesJob Description · Job DescriptionFor a Tax Manager, this is the stuff of dreams: the ability to work where you are most productive and the opportunity to make a difference for the clients you work with. On top of that, you get to work with a team that doesn't take themselves too ...
-
Manager, Information Technology-Remote
2 weeks ago
Navitus Health Solutions LLC Madison, United StatesJob Description · Job DescriptionLumicera Health Services Powered by Navitus · Innovative Specialty Pharmacy Solutions- Lumicera Health Services is defining the "new norm" in specialty pharmacy to optimize patient well-being through our core principles of transparency and steward ...
-
External Contract Manufacturing Manager
3 weeks ago
Exact Sciences Madison, WI, United StatesHelp us change lives · At Exact Sciences, we're helping change how the world prevents, detects and guides treatment for cancer. We give patients and clinicians the clarity needed to make confident decisions when they matter most. Join our team to find a purpose-driven career, an ...
-
Contracts Manager
2 weeks ago
ESKER INC Middleton, United StatesJob Description · Job DescriptionDescription:The Contracts Manager plays a vital role in ensuring the smooth and efficient management of contracts throughout their lifecycle. This position collaborates with various teams, including Lega Sales, Professional Services, and Finance, ...
-
Contracts Manager
1 week ago
ESKER INC Middleton, United StatesJob Description · Job DescriptionDescription:The Contracts Manager plays a vital role in ensuring the smooth and efficient management of contracts throughout their lifecycle. This position collaborates with various teams, including Lega Sales, Professional Services, and Finance, ...
-
Contracts Manager
2 weeks ago
Esker Inc Middleton, WI, US, United States:The Contracts Manager plays a vital role in ensuring the smooth and efficient management of contracts throughout their lifecycle. This position collaborates with various teams, including Lega Sales, Professional Services, and Finance, to facilitate contract negotiations, draftin ...
-
Contracts Manager
1 week ago
Esker Inc Middleton, WI, US, United States:The Contracts Manager plays a vital role in ensuring the smooth and efficient management of contracts throughout their lifecycle. This position collaborates with various teams, including Lega Sales, Professional Services, and Finance, to facilitate contract negotiations, draftin ...
-
Team Lead, Account Management-Remote
5 days ago
Navitus Health Solutions Madison, United StatesJob Description Job Description 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 t ...
-
Team Lead Account Management Remote
1 day ago
Navitus Health Solutions Madison, United StatesJOB REQUIREMENTS: · 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 Navi ...
-
Team Lead, Account Management-Remote
1 week ago
Navitus Health Solutions Madison, United StatesJob Description · Job Description · 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 w ...
-
Project Manager, Client Operations-Remote
1 week ago
Navitus Health Solutions LLC Madison, United StatesJob Description · Job DescriptionEpiphany Rx powered by Navitus Health SolutionsPutting 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 medic ...
Specialty Clinical Network Contracting Manager-Remote - Madison, United States - Navitus Health Solutions LLC
Description
Job Description
Job DescriptionPutting 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.
Due to growth, we are adding this Specialty Clinical Network Contracting Manager to our Specialty Pharmacy Management department.
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.
The Specialty Clinical Network Contracting Manager (SC/NCM) is responsible for providing clinical pharmacy insight for various specialty services provided by Navitus along with the management of all applicable network pharmacy contracting, issue management, reporting, and network strategy in support of Navitus' objectives. The SC/NCM's primary role is to deliver and coordinate specialty projects on schedule, within budget and scope, meeting the expectations of all stakeholders accompanied with the development, implementation, execution, and ongoing management of network pharmacy contracts and relationships with specialty clients and vendors for all lines of business. The SC/NCM will manage the operation and direction of specialty projects and will evaluate, execute, and provide ongoing oversight for network pharmacy contracts to evaluate, implement and ensure all contracts remain in compliance with all contractual obligations. This will include assisting with issues that may arise with any specialty product, network coverage needs, contract negotiations, reimbursement issues and as well as other specialty pharmacy related projects and contract initiatives across all lines of business and geographies (Commercial, Medicare and managed Medicaid).
Is this you? Find out more below
How do I make an impact on my team?
What our team expects from you?
What can you expect from Navitus?
#LI-Remote
