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Navitus Health Solutions

Transparent PBM pass-through rebates for plans

RN Utilization Case Manager

Medical, Clinical & VeterinaryConfirmed live in the last 24 hours
Full-timeEarth City, MO, USANo salary listed

About the Job

Requirements

  • An Associate’s degree in Nursing or a Bachelor of Science in Nursing is required.
  • A current, active Registered Nurse license in good standing with the applicable State Board of Nursing is required.
  • Utilization and case management experience is required.
  • Experience in an infusion setting, physician office, or pharmacy is required.
  • Expert proficiency with Microsoft Office Suite is required.

Responsibilities

  • Review chart notes and perform utilization management on a patient- and drug-specific case basis.
  • Coordinate facilitation of patients’ specialty drug treatment, ensuring timely delivery to the appropriate site of care.
  • Handle case assignments, review case progress, properly document case notes, and determine case closure.
  • Follow established procedures, processes, and standards for production, productivity, quality, and customer service, and meet performance targets for speed, efficiency, and quality.
  • Complete care management clinical escalations and escalate to account management as appropriate.
  • Ensure all external and internal customers receive the level of customer service required by Archimedes and serve as a representative of Archimedes to all external customers.
  • Participate in, adhere to, and support compliance, people and culture, and learning programs.
  • Perform other duties as assigned.

Desired Qualifications

  • A Bachelor of Science in Nursing is preferred.
  • A Master of Science in Nursing is a plus.
  • Experience managing specialty medications for patients with chronic illness is highly preferred.

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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