Pharmacist, Population Health

Navitus • Montpelier, VT • 1d ago

This job was posted by https://www.vermontjoblink.com : For more information, please see: https://www.vermontjoblink.com/jobs/1433889\ \ Overview\

Navitus Health Solutions is seeking a Pharmacist, Population Health to join our team!

The Pharmacist, Population Health will be responsible to perform duties related to the development, implementation, outcomes reporting, and ongoing administration and support of Navitus Clinical Programs including Drug Utilization Review (i.e., RDUR, CDUR), Health Management (i.e., clinical edits, Asthma Management, COPD Management, Pharmacogenomics, Pharmacoadherence, Prescriber Insights, MTM), and other strategic clinical initiatives (i.e., Residency Program) across all lines of business. The Pharmacist, Population Health will also provide support to other clinical areas including Account Management, Lumicera, Drug Information and Pipeline, and the Pharmacy and Therapeutics (P&T) Committee.

Additionally, the Pharmacist, Population Health is responsible for reviewing, evaluating, and sharing the health outcomes and utilization data for program management and development. The Pharmacist, Population Health will develop and maintain appropriate clinical, evidence-based documentation that supports PBM programs. The primary functions involve ensuring that Navitus can provide clinically sound programs (including products, edits, and reports) in the most cost-effective manner and utilize technology to implement clinical programs. This utilization of technology frequently involves translation between technical guidelines and clinical program business requirements as well as program testing.

Is this you? Find out more below!

\ \ Responsibilities\

How do I make an impact on my team?

Lead the development of new clinical programs and manage the

maintenance of existing programs

Facilitate communication and education to clients, members,

providers, and internal staff regarding clinical programs and program outcomes

Provide clinical outreach to members, prescribers, and pharmacy

providers to enhance care coordination

Provide support to operational departments on the implementation of

various PBM programs and daily functioning in support of member/patient quality of care. This involves frequent interdepartmental collaboration and guidance to develop, implement, and maintain all clinical programs

Have strong knowledge of various standards, regulations, and

guidance including Medicare Part D, PQA, and HEDIS measures and concisely communicate that information to stakeholders and clients

Assist Residency Program Director (RPD) with the PGY1 Managed Care

Residency Program

Provide leadership, training, supervision, and strategic direction

to Product Managers

Provide expertise through active involvement with the Specialty

Clinical Group

Participate in the Coverage Determination (Certification, Prior

Authorization, Medical Exception, Exception to Coverage, etc.) process when needed

Provide clinical expertise related to formulary decisions made by

the P&T Committee and Formulary Advisory Committee

Other duties as assigned

\ \

Qualifications\

What our team expects from you?

Bachelors degree in Pharmacy or PharmD required.

Current, unrestricted licensure as a Registered Pharmacist in the state of residence, or the ability to gain reciprocity within 4 months.

2+ years of clinical experience, or clinical or managed care pharmacy practice residency and 1-year clinical experience.

Knowledge of PBM industry, formulary management, pharmacy claims and managed care principles and practices desired.

Proficiency in d\ \ \ \ Equal employment opportunity, including veterans and individuals with disabilities.\ \

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