Navitus Health Solutions

Principal, PBM Business and Regulatory Strategy

Navitus Health Solutions

full-time

Posted on:

Location Type: Remote

Location: Idaho • United States

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Salary

💰 $128,961 - $161,201 per year

Job Level

Lead

About the role

  • Drive cross‑functional operational requirements and implementation (scope, milestones, owners, dependencies, and success criteria) spanning Product, Operations, Technology, and Customer Success.
  • Coordinating complex pharmacy benefits relationships through operational and contract understanding, inter-entity dynamics, and reimbursement structures and strategies.
  • Facilitate solution design to reflect regulatory intent and operational practicality.
  • Manage traceability from requirement to control to process/tech change to evidence.
  • Define/validate preventive & detective controls; align with policies, standards, and procedures.
  • Establish accompanying fit‑for‑purpose evidence models (reports, dashboards, logs, audit trails) and/or testing protocols to demonstrate ongoing adherence to regulatory requirements.
  • Ensure policies, procedures, desk‑level work instructions, and training are updated prior to effective dates.
  • Coordinate change readiness and adoption with affected teams including recommending content relevant to client impact and experience.
  • Exercise authority to gate/hold releases when regulatory or control gaps create material risk, escalating through leadership as needed.
  • Sign‑off authority on control adequacy and evidence sufficiency for go‑live operational readiness.
  • Monitor reduction in post‑go‑live defects and implement root cause analysis or defect remediation plans supportive of the regulatory environment.
  • Other duties as assigned.

Requirements

  • Bachelor’s degree in business, or other directly applicable field, or equivalent work experience, required.
  • 10+ years’ experience in healthcare/health plan/PBM regulatory compliance, pharmacy operations management, regulatory operations, or operational implementation required.
  • Demonstrated success leading cross‑functional regulatory change.
  • Ability to translate regulatory text into practical requirements, contractual implications and control designs; strong partnership with Legal and technical/operational teams.
  • Proficiency with risks, issues, testing, and evidence advanced communication, facilitation, and influence skills across executive to front‑line levels.
  • Strong knowledge of pharmacy contracting and/or pharmacy benefits regulatory requirements.
  • Proven ability to lead cross-functional teams and influence senior stakeholders.
  • Participate in, adhere to, and support compliance program objectives
  • The ability to consistently interact cooperatively and respectfully with other employees.
Benefits
  • 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
  • Educational Assistance Plan and Professional Membership assistance
  • Referral Bonus Program – up to $750!
Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills & Tools
regulatory compliancepharmacy operations managementoperational implementationcontractual implicationscontrol designsrisk managementevidence modelsroot cause analysisdefect remediation
Soft Skills
cross-functional leadershipcommunication skillsfacilitation skillsinfluence skillspartnershipcooperationrespectfulness