Sr. Director, Pharmacy Network Informatics

Company

Navitus

About Us

Navitus - Putting People First in Pharmacy - 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._____________________________________________________________________________________________________________________________________________________________________________________________________________. Current associates must use SSO login option at https://employees-navitus.icims.com/ to be considered for internal opportunities. ____________________________________________________We are committed to providing equal employment opportunity to all applicants and employees and comply with all applicable nondiscrimination regulations, including those related to protected veterans and individuals with disabilities. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, or handicap.

Pay Range

USD $147,648.00 - USD $184,559.00 /Yr.

STAR Bonus % (At Risk Maximum)

17.50 - Sr Director

Work Schedule Description (e.g. M-F 8am to 5pm)

M-F 8am to 5pm CT

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. Director, Pharmacy Network Informatics to our team!

 

The Sr. Director, Pharmacy Network Informatics will oversee, lead and provide strategic direction to the Navitus Network Pricing Team, Pharmacy Business Impact Analysts, Retail and Specialty Contract Analysts, Network Reporting Team, Business Impact Analyst, Reconciliation, Pharmacy Contract Performance, and the Navitus MAC Team to ensure the success of business needs, financial guarantee, and risk analysis.  The Sr. Director will ensure collaboration, partnerships and support of the Navitus Provider Services, Sales, Account Management, Underwriting, Finance, and Government Programs departments The Sr. Director will leverage use of emerging technologies and analytics to assist internal and external customers to make informed decisions to decrease Navitus’ financial risk and increase Navitus’ sales, technical advancements, and marketing opportunities and will serve as the Provider Services primary subject matter expert on all existing and prospective clients and RFP response. 

 

Is this you? Find out more below!  

Responsibilities

How do I make an impact on my team?   

• Direct the adequacy and performance of Navitus’ provider networks via data modeling, analysis, and reporting received from the team. 
• Develop and oversee pharmacy business intelligences dashboards, reports, and analytics infrastructure. 
• Partner with internal stakeholders such as Finance, Underwriting, Operations, Compliance, IT to align pharmacy performance metrics, forecasting, KPI’s with organizational goals. 
• Lead and effectively manage all risk based pharmacy performance projects to ensure proper reimbursement, risk mitigation management and forecasting to maintain contract compliance effectively communicating to internal and external stakeholders. Leverage large and complex datasets to model financial, clinical, and operational outcomes; translate findings into implementable strategies that optimize benefit design and network performance. 
• Effectively interpret data models to establish prospect and renewal pricing and forecast solutions to secure new/retained business. 
• Support and advise senior leadership regarding provider agreements, administration of the MAC Program, and network pricing strategy for prospects and renewals. 
• Collaborate and lead informatics key objectives with Provider Services team leads in areas including retail and specialty contracting, pharmacy operations, and client pharmacy services support.  
• Responsible for maintaining and managing a competitive, market leading MAC Program including working with pharmacies, clients, vendors, and internal department liaisons to implement and maintain a compliant MAC Program.   
• Main oversight for monitoring and maintaining Navitus generic effective rate, cost-plus, and other contractual requirements and pharmacy pricing methodologies with applicable providers and facilitating adjustments in Navitus’ adjudication system to meet contractual terms. 
• Ownership of applicable data sources and models, including limitations of use an