Navitus

Director, Clinical Pharmacy Operations

Managed Care Pharmacist for: Director, Clinical Pharmacy Operations Location: Madison, WI Corporate Headquarters Background: Navitus Health Solutions, LLC (Navitus) is a health services company specializing in pharmacy benefit management (PBM) services. It was founded in 2003 as a privately-owned joint venture between Dean Health Plan, Inc. and PBM Ventures, LLC and is headquartered in Madison, Wisconsin with operations in Appleton, Wisconsin. Navitus’ mission is to lower drug costs, improve health and provide superior customer service in a manner that inspires trust and confidence. With over 500,000 covered lives and 105 employees, Navitus expects continued rapid regional and national growth. As a leader in complete transparency, at Navitus nothing is hidden. Clients know how their benefits are managed because every contract is available for review. This approach starts with pricing and extends throughout Navitus’ business practices. Stewardship is critically important at Navitus with a focus on the informed, responsible management of services for those entrusted to its care. This is a vital part of Navitus’ mission and it is carried out with knowledge that comes from two decades of experience. Navitus is also focused on performance. It has a commitment to excellence that always puts the people it serves first. Navitus embraces the pay-for-performance model, using it as a framework to meet the needs of its clients over the long run. The result is that Navitus sets a new industry standard. Navitus provides a wide variety of prescription drug services, including benefit design, formulary management, pharmacy network management, and innovative clinical programs. It focuses on managing the entire pharmacy benefit, balancing cost savings, clinical quality and net pharmacy cost. This aligns the incentives of the administrator, payers and beneficiaries. It is a unique approach, developed and implemented by an experienced management team with a proven track record based on world-class metrics. Our People: Navitus looks for highly skilled people who are unafraid to apply their talent and knowledge in new and innovative ways. Our team includes professionals in clinical services, clinical program management, sales and marketing, client services, customer care (call center), claims processing, information technology, plan administration, plan implementation, finance and accounting, audits, compliance, health informatics, and administration. Our Culture: Navitus is a place where growth is encouraged, and where employees engage in multi-disciplinary project teams, enjoy diversity and variety in many ways, and make a positive difference. Navitus’ team welcomes new ideas and shares a passion for excellence. Our Team Members and our Clients are Navitus’ greatest assets. Job Summary: The Director of Clinical Pharmacy Operations is responsible for the leadership and management of the Clinical Services department including the training and development of all staff. The Director is responsible for leading the department to provide clinical content, operational expertise and oversight of Prior Authorization; Medicare Part D Medication Therapy Review; Drug Information, Formulary and Pipeline Surveillance; and Drug Utilization Review and Health Management clinical operations. The Director is also responsible for pharmacy practice issues for the PBM, including policies and procedures and the annual review of formularies and prior authorization criteria. The Director provides collaborative input for the promotion and development of new concepts and proposes modifications to existing clinical programs. Additionally the Director is responsible for all functions and activities of the Pharmacy and Therapeutics Committee, and the Clinical Advisory Group, including the development of formulary drug monographs, prior authorization criteria, and collaborates on position statements for clinical programs being presented to the Pharmacy and Therapeutics Committee. The Director will recommend, develop, implement and evaluate department goals, objectives, policies and procedures related to the Clinical Services department. Position reports to a senior member of the Executive Committee. Additional Responsibilities: • Responsible for clinical content of client, member and internal communications and education regarding all clinical initiatives • Responsible for team and staff development and also plays a key role in the interviewing, selection, coaching and mentoring of pharmacists within the Clinical Services department. • Provides clinical expertise for the Industry Relations and Contracting department in order to maximize quality and cost-effectiveness of drug therapy; provides clinical expertise for the Clinical Program Development area to maximize effectiveness of programs. • Responsible for the continuous review of the literature to identify opportunities for improvement in efficiency, accuracy, and appropriateness of drug therapy; and for inclusion in existing clinical programs • Effectively manage area responsibilities. This includes the following: manage and support recruitment of staff to support corporate goals, objectives and culture, and manage appropriate budget expenses • Maintain open lines of communication with other functional areas/departments • Provide effective communication of Navitus’ vision, mission, values, goals, and policies • Participate in meetings and committees regarding goals, vision, and strategic plans • Provide leadership and direction within Navitus Essential Background Requirements: Education: A minimum of a Bachelors Degree in Pharmacy or Pharm. D. Experience: Minimum of five years of management and clinical experience in a managed care environment. Knowledge of the PBM industry, formulary systems, pharmacy claims and managed care pharmacy desired. Exceptional leadership and management skills, excellent clinical skills, and the ability to apply sound clinical judgment and good decision-making to a variety of situations. Proficiency in drug literature and clinical trial evaluation, including proficiency with electronic databases (e.g., Micromedex, Medline, Internet) preferred. Ability to reason and translate clinical information into a manner appropriate for clinical systems, and clinical and non-clinical audiences. Emphasis is placed on problem-solving skills, including identifying and accepting a challenging situation and creating and implementing a solution. Requires attention to detail in order to ensure projects are clinically, editorially, and systems appropriate and accurate, and can be successfully operationalized. It is very important for this position to be able to translate clinical information into process logic. Proficiency in MS Word, Excel, Access, and Power Point including use of tables, charts and figures preferred. Key Skills/Competencies: • Leadership and ability to communicate a compelling vision • Critical thinking/Problem-solving • Judgment and Decision-making • Influence and Persuasion • Negotiation Skills and Conflict Resolution/Management • Communication Skills (written, verbal/presentation and active listening) • Teamwork/Collaboration • Customer-Centric Skills, and ability to understand internal and external customers • Strategic Thinking/Systems Aptitude Thinking • Project Management and ability to prioritize continually/multi-task • Understanding and coping with constant change • Ability to build and manage relationships • Ability to see the current state, in all its ambiguity • Ability to look for explanations of that state without blaming other people • Ability to work with people to change the current state to the desired state, learning about the project and program as the work evolves How to Apply: Please view our website, www.navitus.com, for additional information about our company, employment opportunities, and to submit an application, cover letter and resume. To apply, use the “Quick Links” drop-down menu in the upper right corner of the home page to access “Employment Opportunities” and apply online or by alternate means. Navitus Health Solutions is an Equal Opportunity Employer: Disabled/Veterans/Male/Female/Minority.

Location: Madison, WI
Job Code: Direcotor, Clinical Pharmacy Operations
Region:
Position Type: Full Time

Submit your information