Navitus Health Solutions, LLC

Compensation

Full Description

Company Navitus About Us Epiphany - Epiphany Rx powered by Navitus Health Solutions - Putting People First in Pharmacy- Epiphany's parent company Navitus was founded as an alternative to traditional pharmacy benefit manager (PBM) models. We are committed to removing cost from the drug supply chain to make medications more affordable for the people who need them. At Navitus, our team members work in an environment that celebrates diversity, fosters creativity and encourages growth. We welcome new ideas and share a passion for excellent service to our customers and each other. Pay Range USD $58,460.00 - USD $70,434.00 /Yr. STAR Bonus % (At Risk Maximum) 5.00 - Salaried Non-Management except pharmacists Work Schedule Description (e.g. M-F 8am to 5pm) M-F 8:30am-5pm, CST Remote Work Notification ATTENTION: Navitus is unable to offer remote work to residents of Alaska, Hawaii, Maine, Mississippi, New Hampshire, New Mexico, North Dakota, Rhode Island, South Carolina, South Dakota, West Virginia, and Wyoming. Overview Due to growth we are adding a Sr. Coordinator, Clinical Client Services to our team! The Sr. Coordinator, Clinical Client Services (SrCCSC) is a highly motivated professional with at least 4 years of successful experience interfacing directly with clients and clinical team to assist Clinical Account Executives (CAE) in completing the tactical and operational tasks required to meet the needs of our PBM clients. The position is responsible for participating in issue resolution and daily support of client requests, responding to general internal and external inquiries regarding claims processing, and assisting new client implementations. In addition, this role requires the individual to develop standards and ad hoc clinical reports and will work cross functionally with other internal Navitus stakeholders to assure claims process correctly. This may include development of Prior Authorization loads for new and existing clients based on Navitus or State Medicaid changes in formularies and assisting in creating mailing lists for the changes listed above. Responsibilities also include serving as liaison between some Third-Party Administration (TPA) clients assisting the CAE in day-to-day clinical maintenance as well as assisting in the implementation of the groups. The SrCCSC will assist with developing efficiencies in current and future processes within the department and in how the department works with other Navitus teams. Is this you? Find out more below! Responsibilities How do I make an impact on my team? Populate data for Consultative reviews, create consultative review and BOB Excel templates Create custom objects in 3D for Clinical includes consultative review, BOB data, high-cost medications i.e. Harvoni, Praluent Repatha, Kaleydeco, Acthar HP, Synagis Coordinate assembly and processing of prior authorizations (MPAs) for new client implementations and formulary changes done by Navitus or Health plan clients Prepare new and revise existing training documents relevant to department Conduct Clinical Coordinator training (Navigate 3-D, Navi-Claim, etc.) and serve as resource and mentor to new team members Assist in development of new procedures within the clinical department. Draft policies that accompany these workflows Support/back up the CAE responsibilities Travel to Client sites Other duties as assigned Qualifications What our team expects from you? High school diploma or equivalent required, Associate’s or bachelor’s degree preferred 2 years of successful experience as a Clinical Client Services Coordinator-II preferred Knowledge of PBM or health care industry preferred Ability and desire to work with external client contacts and partners to manage day to day clinical activities for TPA’s Excellent verbal and written communication as well as strong organizational and multi-tasking skills and problem-solving capabilities PC skills: Microsoft Office, Email, Internet, and other applications as required, preferred advanced Excel knowledge Valid State Driver’s License and current Automobile Insurance Policy CPhT Preferred Participate in, adhere to, and support compliance program objectives The ability to consistently interact cooperatively and respectfully with other employees What can you expect from Navitus? • Top of the industry benefits for Health, Dental, and Vision insurance • 20 days paid time off • 4 weeks paid parental leave • 9 paid holidays • 401K company match of up to 5% - No vesting requirement • Adoption Assistance Program • Flexible Spending Account #LI-Remote Location : Address Remote Location : Country US