- Provide leadership, training, supervision, and strategic direction to department Pharmacists and Product Managers.
- Support and motivate team members to ensure consistent and maximum performance levels.
- Facilitate staff development through mentoring, reinforcement of expectations, and encouraging personal professional development.
- Assist with the fiscal management of the department, including forecasting, budget development, staffing, and trending of programs in support of Navitus' strategic and business initiatives.
- Proactively anticipate and solve population health related issues, focusing on the Medicaid and Medicare populations.
- Lead 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 Navitus.
- Lead discussions with clients, members, providers, vendors, and internal staff regarding Medicaid and Medicare clinical services and outcomes.
- Serve as a key stakeholder and decision-maker on implementation of new Medicaid and Medicare clinical requirements.
- Have 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 clients.
- Assist RPD with the accredited PGY1 Managed Care Residency Program.
- Support URAC and NCQA clinical initiatives and projects as needed.
- A minimum of a bachelor's degree in pharmacy or Pharm D. Current unrestricted licensure as an RPh in the State of Wisconsin or the ability to gain reciprocity within 4 months of employment is required.
- Minimum five years clinical experience, or clinical or managed care pharmacy practice residency and three years clinical experience. Knowledge of PBM industry, formulary management, clinical outcomes research, pharmacy claims, and managed care principles and practices desired.
- Participate in, adhere to, and support compliance program objectives
- The ability to consistently interact cooperatively and respectfully with other employees
- Hours/Location: Monday-Friday 8:00-5:00pm, 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
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Manager, Government Clinical Services-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 Manager, Government Clinical Services to our Clinical Program 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 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 timely program execution, represents 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, along with the Program Manager, is responsible for duties related to the development, implementation, outcomes reporting, and ongoing administration of Navitus' clinical programs, reports, and edits for Medicare and Medicaid populations.
The Manager provides support to other clinical areas including Account Management, Drug Information, and Compliance. Additionally, the Manager is responsible for the oversight and sharing of health outcomes, clinical measures, and utilization data used for program management and development. This position will be an active member of the Clinical Services Team within the Health Strategies Division.
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