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Navitus Health Solutions

Transparent PBM pass-through rebates for plans

Pharmacy Technician - Retrospective Case Management

PharmacyConfirmed live in the last 24 hours
Full-timeMissouri, USANo salary listed

About the Job

Requirements

  • A high school diploma or GED is required.
  • A Pharmacy Technician license is required.
  • Proficiency in Microsoft Excel, PowerPoint, and Word is required.
  • Participate in, adhere to, and support compliance program objectives.
  • Consistently interact cooperatively and respectfully with other employees.

Responsibilities

  • Develop and deliver follow-up messages to physicians related to case-management documentation.
  • Organize peer-to-peer collaboration between physicians and pharmacists.
  • Manage and act as the primary point of contact for high-cost case-management and retroactive drug-utilization cases, including coordinating outbound physician notifications and inbound case documentation.
  • Manage queues and organize documents for pharmacy technician work related to case management.
  • Perform retrospective case management related to provider-denial and low-clinical-acuity cases identified by clinical policies and guidelines.
  • Participate in, adhere to, and support compliance, people and culture, and learning programs.
  • Perform other duties as assigned.

Desired Qualifications

  • Pharmacy, hospital, or managed-care experience is preferred.
  • Benefit knowledge and experience are 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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