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Navitus Health Solutions

Transparent PBM pass-through rebates for plans

Pharmacist - Telehealth

PharmacyUpdated on Nov 5
Full-timeRemote in USA

About the Job

Requirements

  • Maintain current, unrestricted Registered Pharmacist licensure in the state of residence, or be able to gain reciprocity within four months where required by state law or client contract.
  • Maintain continuing education credits needed to keep pharmacist licensure active.
  • Have at least two years of clinical experience, including direct consultation experience.
  • Have knowledge of healthcare industry practices and HIPAA regulations.
  • Participate in, adhere to, and support compliance program objectives.

Responsibilities

  • Conduct medication therapy management (MTM) and expanded clinical programs in accordance with Centers for Medicare & Medicaid Services (CMS) requirements.
  • Develop clinical algorithms, pathways, and call scripts to support pharmacy staff in delivering MTM services.
  • Review and update algorithms and call scripts at least yearly and when clinical guidelines are updated.
  • Develop documentation standards for clinical outreach.
  • Collaborate with other Clinical Engagement Center staff to develop and maintain a high-quality, consistent MTM product.
  • Assist Clinical Engagement Center leadership in developing programs to support STAR ratings outreach.
  • Provide Medicare Part D clinical, operational, and educational support by maintaining knowledge of updates and regulations regarding the MTM program and Medicare Part C and D performance measures (STAR ratings).
  • Serve as a preceptor for Advanced Pharmacy Practice Experience (APPE) students within the Clinical Engagement Center department.
  • Adhere to compliance and HIPAA regulations.
  • Perform other duties as assigned.
  • Consistently interact cooperatively and respectfully with other employees.

Desired Qualifications

  • Experience as a clinical call center lead.
  • Experience as a member of a multidisciplinary team.
  • Professional pharmacy benefit manager (PBM) industry work experience.
  • Knowledge of applicable data privacy practices and laws.
  • Spanish-speaking ability.

About the Company

Navitus Health Solutions

Transparent PBM pass-through rebates for plans

Navitus Health Solutions is a pharmacy benefits manager that offers transparent pricing by passing 100% of negotiated rebates and discounts to its health-plan clients. It runs a spend-management clinical model designed to control drug costs from the outset while supporting member health, delivering both immediate value and long-term savings as drug spend trends are managed over time. The company markets its services through its portfolio brands—Navitus, Lumicera, and Archimedes—and serves over 18 million members across 800 clients, including public and private employers, unions, health plans, and health systems. It is owned by SSM Health and Costco Wholesale Corporation. Unlike traditional PBMs with opaque pricing, Navitus emphasizes transparency and direct savings for plan sponsors. The overarching goal is to reduce prescription drug costs for plans while improving member health outcomes.

Company size
1,001-5,000
Company stage
Not listed
Total funding
Not listed
Headquarters
Appleton, WI
Founded
2003

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