Navitus Health Solutions

Software Engineer

• Provide responsive technical assistance and document configuration to support processes.
• Work independently to understand and document business needs.
• Work with additional functional teams to ensure optimal operations of application development.
• Support change control and testing processes for modifications to application systems.
• Research and recommend innovative, and where possible automated approaches to business needs.
• Identify approaches that leverage our resources and provide economies of scale.
• Develop and maintain documentation of custom processes.
• Provide backup administration support to other ASA teammates.
• Provide after-hours support.
• Development within Microsoft SaaS platforms including Teams, SharePoint, and CoPilot
• Development within the Microsoft Power Platform with hands-on experience in RPA development, with expertise in complex bot development and automating revenue-related workflows preferred.
• Development within Atlassian SaaS platforms
• Development within Oracle Fusion, ORMB, OIC ERP platforms
• Development within Dynamics (D365) CRM Platform
• Development Administration within Data movement tools like SmartConnect
• Other duties as assigned

Senior Developer, Application Systems

Operations

• Scale the operational processes to ensure a superior patient experience and high quality clinical management
• Develop, train and staff the team of case managers and pharmacists
• Liaison between the team and account management to ensure the customer is informed on progress, successes and potential challenges
• Support the development of activity, quality and performance reporting
• Be the business owner of the case management and prior authorization technology platform and collaborate with IT on enhancements and solutions sets

Director, Clinical & Medical Operations

• Conduct operational redesign and develop and execute business strategies that increase service levels, operational capabilities, and efficiencies.
• Including oversight of pharmacy capacity, new pharmacy locations, and pharmacy redesign
• Direct and oversee Patient Services and Specialty Programs staffing requirements by analyzing trends, developing forecasts, researching business requirements, and analyzing workflows, in conjunction with WFM function
• Collaborate with IT leadership to ensure necessary systems and applications are in place to support fulfillment operations and that all operational systems are continuously evaluated for proper operation, efficiency, and tracking/reporting capabilities
• Develop and implement strategic plans for the operational infrastructure of systems, processes and personnel designed to accommodate the growth objectives and new service offerings of the organization
• Develop and implement continuous operational improvements focused on enhancing the level of patient care while optimizing the customer experience
• Collaborate with leaders from across the organization to optimize processes to improve efficiency, safety, and patient experience.
• Ongoing monitoring, evaluation, and reporting of pharmacy service KPIs to other Pharmacy Managers and Executive Leaders
• Assist in the creation and reporting of ongoing Quality Improvement Projects, as well as actively participating and contributing to the Quality Oversight Review Committee
• Investigate, present, and create business cases around new technology solutions and/or processes to aid in either more efficient pharmacy fulfillment operations or enhanced patient experience
• Develop and oversee an efficient, cost effective, safe, and patient-centric fulfillment strategy across all fulfillment locations, encompassing fulfillment process, packaging, shipping, and service delivery and recovery
• Other duties as assigned

Director, Specialty Pharmacy Fulfillment Operations

Client Services Representative

• Support/back up the CSE, Senior CSC and CSC responsibilities
• Create and present data for Strategic Business Plans, VALUE Summaries, and Performance Standard reports
• Investigate/follow-up if Performance Guarantees are not met and present those results to their assigned clients
• Conduct Client training (Client Portal Site, Navi-Claim, etc.)
• Assist with escalated member/Client issues requests
• Identify and present Client opportunities to improve costs, service and health
• Contract maintenance and performance
• Travel to Client sites
• Provide mentoring to the coordinator levels and CSEs
• Other duties as assigned

Senior Client Services Executive

General Counsel

• Dedication to being part of a high-performing team, providing exceptional legal services, and helping Archimedes continue to grow and develop.
• Provide analysis and counsel to Archimedes on legal issues related to contracts, statutes and regulations, products, employment law, intellectual property, financial offerings, financial structuring, real estate transactions, and strategic planning.
• Work collaboratively with Lumicera and Navitus teams to ensure compliance with relevant law, ethical business practices, and Navitus’ mission and values.
• Ensure the effectiveness and efficiency of the Archimedes Legal Team in meeting organizational needs.
• Draft, review, and negotiate contracts on behalf of Archimedes; maintain and proactively update contract templates in compliance with changing business needs and legal requirements; write and administer complex vendor, client, and employment contracts.
• Manage processes related to licensing and regulatory requirements for Archimedes.
• Inform the development of new Archimedes initiatives from a legal perspective and provide guidance on legal issues that help shape the organization’s direction and impact as a whole related to contracts and IT systems.
• Update, review and approve policies and procedures related to Archimedes legal needs.
• Research and analyze statutes, judicial decisions, legal articles, contracts, and legal codes as needed.
• Maintain a working knowledge of applicable state, federal, and local laws and regulations and relevant policies and procedures to ensure actions are consistent with Archimedes’ mission and values as well as organizational and professional ethical requirements.
• Other duties as assigned.

Assistant General Counsel

Analyst

• Prepare monthly finance accrual recommendations for review by Sr. Manager and support leaders as needed for monthly accrual meeting with Finance
• Responsible for maintaining and designing team SharePoint site and identifying opportunities for enhancements based on trending of team productivity and accomplishments to help ensure successful completion of team’s work and meeting Navitus’ strategic and business initiatives
• Accountable for data quality, completeness and accuracy in team workflow tools, including RFP/renewal deadlines and new client implementations
• Accountable for maintenance of frequently used resource documents on team SharePoint site, including performance guarantee library, FAQs, subject matter experts and standard performance guarantee contract exhibit
• Guide existing and train new contract performance analysts as well as inspire positive communication within the entire contract performance team to work together to achieve common goals
• Assist Contract Performance team with the Request for Proposal (RFP) process process which includes but is not limited to the following: Review RFP requested performance guarantees, Compare to previously requested guarantees for consistency, Present findings to Contract Performance team, Perform outreach for departmental approval of performance guarantees, Consolidate responses and review with Contract Performance team, Deliver RFP response to Proposal team
• Upon Client win notification, review service, network and/or rebate guarantees agreed to during the RFP process and notify operational areas
• During contract negotiations, analyze contract redlines, perform outreach for departmental approval of any performance guarantee edits and prepare final recommendations
• Upon contract execution notification, communicate final contract guarantees to operational areas prior to go-live
• Responsible for Performance Guarantee (PG) reporting which includes but is not limited to the following: Monitor the collection of monthly, quarterly and annual service performance guarantee results from process owners, Identify, research and facilitate corrective action for missed guarantees with the process owners and Client Services team and determine penalty payout when applicable, Analyze underperformance in network financial performance reports and notify Pharmacy Networks team to solicit cause and next steps if needed
• Assists the Manager with the development, documentation, implementation, and maintenance of performance guarantee data repositories and report writing programs
• Prepare PG-related reporting for senior leadership as needed
• Schedule, facilitate and document meetings and discussions
• Participate as a member of cross functional workgroups, teams, and committees, as assigned
• Assist with the creation and maintenance of departmental work instructions
• Other duties as assigned

Senior Analyst, Contract Performance

Paralegal

• Supports Navitus, Lumicera, and their subsidiaries by managing licensing processes.
• Drafts legal documents and templates, manages document templates and corporate legal records.
• Performs records and legal research and prepares correspondence under general supervision.
• Identifies, reviews, and interprets legislation and regulatory environment changes impacting Navitus.
• Provides support and analysis related to applicable regulations.
• Conducts legal search on relevant laws, statutes, and regulations, prepares memorandums and action plans.
• Prepares legal documents, such as contracts for review, approval, and use by attorneys.
• Files legal documents and correspondence in digital and physical filing systems.
• Ensures effective indexing and filing of legal documents.
• Researches and analyzes statutes, judicial decisions, legal articles, contracts, and legal codes.
• Supports attorneys by communicating and obtaining information, following up on delegated assignments.

Senior Paralegal

Risk

• Assist with and facilitate enterprise-wide Data Governance program activities and collaborates on strategic initiatives for data governance, data quality and metadata activities
• Supports Data Governance Council and Data Governance Committee, ensures execution of follow-up tasks assigned from the meetings, provides education and support for data governance across the organization
• Accountable for the analysis, development, and build of an Enterprise Data Catalog while also building related data lineage to directly support privacy, security, legal, and audit initiatives
• Designs and recommends data quality improvement opportunities
• Works with the business to develop and publish KPI’s as it relates to data quality and integrity for accessibility across all business areas
• Point of contact for and liaison between business Data Domain Owners, Data Stewards, and IT
• Work with Domain Owners to establish, maintain, and distribute definitions of data elements used by Analytics in conjunction with Domain Owners throughout the organization
• Leads analysis and remediation efforts for complex multi-domain data issues as identified by the business and Data Governance Committee
• Mentors junior team members
• Other duties as assigned.

Senior Analyst, Data Governance

Content Manager

• Seek, build, and edit strategically positioned content that easily integrates into proposals and other sales related documents for various markets (e.g. health plans, government, national accounts, mid-market employers)
• Oversee the accuracy, organization and formatting of library content to keep the proposal knowledgebase current, competitive and usable by the proposal team
• Collaborate with SMEs to convert complex and varying explanations into concise and compelling value propositions and proof points ensuring compliance with Navitus’ brand/style guide and sales strategy
• Identify gaps in the knowledgebase and ensure timely updates of all content positioning and related exhibits through regular content audit reviews
• Work collaboratively with those contributing to and/or drawing from the knowledgebase, such as proposal team members, executives, management teams, business units, partners, and SMEs
• Serve as a proposal content knowledgebase expert by communicating important updates related to processes, messaging and content management, including SME list management, training and alignment
• Serve as a proposal automation software expert to all users in the company.
• Maintain a high level of proficiency with the knowledgebase system and apply new functionality to improve how content is organized, updated and accessed
• Contribute to the department goal of improved efficiency and effectiveness by implementing processes to streamline proactive creation
• Consult system reporting and analytics to gain insights into content preparation and usage to inform training opportunities and improvement efforts
• Demonstrate flexibility and ability to work independently and in a team/collaborative environment
• Share knowledge to build expertise in others
• Perform continuous improvement projects as assigned
• Other duties as assigned

Proposal Content Manager

Pharmacist

• Develop and deliver clinical messages to physicians, members, clients, and consultants
• Manage prior authorization, high-cost cases, claims editing and clinical policy development
• Evaluate and summarize clinical literature as well as financial implications related to medication management options
• Ability to present deep clinical and cost effectiveness information as a peer-to-peer consult

Clinical Pharmacist – Utilization Management

Implementation Specialist

• Accountable for leading and executing growth initiatives with a strong emphasis on high‑quality client implementation
• Oversees and is accountable for quality assurance across client implementations
• Drives accountability for implementation accuracy, completeness, and timeliness
• Leads continuous improvement efforts to strengthen delivery quality and operational controls
• Provides executive oversight of the Implementation, Technical Oversight, and Business Development Systems teams
• Establishes and monitors quality metrics, service standards, and performance indicators
• Identifies, escalates, and mitigates delivery risks
• Owns end‑to‑end issue management
• Establishes and oversees quality assurance and control frameworks
• Partners with the Accreditation and Clinical Quality teams to ensure practices align with accreditation standards
• Partners with Sales, Product, Customer Success, Proposals, and leadership teams to ensure market feedback is reflected
• Collaborates with VP, Enterprise Product Strategy to ensure products and services support delivery quality.

VP, PBM Client Implementation – Delivery Quality

Call Center Representative

• Assists the Call Center Supervisor in managing the performance of the call center
• Ensures all external and internal customers receive the level of customer service required by Archimedes
• Assists in the training and coaching of call center staff
• Establishes and executes clear procedures, processes, and standards for production, productivity, quality, and customer-service
• Reports on trends on the call centers efficiency, customer service, and customer retention

Call Center Team Lead, Member Services

Manager

• Provide leadership, training, supervision, and strategic direction to department Pharmacists and Product Managers.
• Assist with the fiscal management of the department, including forecasting, budget development, staffing, and trending of programs in support of Navitus’ strategic and business initiatives.
• Proactively anticipate and solve population health related issues.
• Lead the development of new clinical programs and manage the maintenance and continuous improvement of existing programs, to keep innovation and evidence-based programs a differentiator for Navitus.
• Serve as a key stakeholder and decision-maker on implementation of new clinical requirements.
• Have strong knowledge of current standards, regulations, and guidance including CMS, PQA, and HEDIS measures and have the ability to concisely communicate that information to stakeholders and clients.
• Assist RPD with the accredited PGY1 Managed Care Residency Program.
• Support URAC and NCQA clinical initiatives and projects as needed.
• Other duties as assigned.

Senior Manager, Population Health

Underwriter

• Maintain and enhance sales support mechanisms for prospective clients
• Calculate risk of pricing metrics and value derived from the relationship with the client
• Review, pro-actively identify, and support implementation of opportunities for rebate, pricing, and discount performance improvement via analysis
• Research external and internal pricing trends and forecasts to contribute to overall pricing strategy
• Maintain databases to support business decisions and inform responses to client or prospective client requests
• Track and report client performance impacts of relevant programs. (e.g. Savings Connect)
• Monitoring of forecasted results as they compare to actuals
• Identify opportunities for client savings or program enhancements
• Perform analyses as requested by internal and external business owners, or in support of identified business objectives
• Develop an understanding of contractual terms and performance to assist in development of program strategies, pricing decisions, and contract language
• Perform quality assurance to ensure accuracy of pricing and processes
• Other duties as assigned

Analyst, Pricing and Underwriting

• Define and execute the company’s Technology strategy aligned with business objectives and growth plans.
• Identify and evaluate emerging technologies to drive innovation and deliver strategic advantage.
• Collaborate with executive leadership, other subsidiaries, and business units to align technology initiatives with organizational priorities.
• Oversee design and implementation of secure, scalable applications, infrastructure, and architectures that meet business and compliance requirements.
• Ensure reliable technology operations, including infrastructure, networks, data management, and security protocols.
• Direct teams employed by the business unit, as applicable, responsible for engineering, development, data warehouse platforms and core technology infrastructure.
• Ensure adherence to enterprise-wide cybersecurity programs to meet industry standards and contractual obligations.
• Ensure compliance with data privacy regulations.
• Manage subsidiary disaster recovery and business continuity plans for technology and collaborate with enterprise response.
• Direct application development, system design, integration, and delivery across the division.
• Lead engineering teams responsible for software development, application platforms, data solutions, and core technology services.
• Optimize modern software development practices, including agile delivery, DevOps, CI/CD pipelines, and cloud-native architectures and solutions.
• Integrate quality into all phases of the SDLC with a focus on testing automation.
• Following the overall enterprise governance and in alignment with other divisional leaders, integrate the use of AI for technology and non-technology teams for measurable business benefits.
• Drive application modernization efforts to improve scalability, performance, and time-to-market.
• Optimize applications, cloud solutions, and development for scalability and performance.
• Align with Technology governance frameworks for transparency and accountability.
• Identify and mitigate technology-related risks; analyze investments, ROI, and advise executive leadership.
• Select and manage technology vendors and partners, ensuring cost-effective solutions.
• Create and manage the technology budget, optimizing resource allocation and in/out-sourcing balance.
• Ensure data accuracy, integrity, and compliance with established governance and security policies.
• Provide strong leadership to technology teams, fostering collaboration, innovation, and continuous learning.
• Participate in, adhere to, and support compliance, people and culture, and learning programs.
• Perform other duties as assigned.