Navitus Health Solutions

Account Executive

• Work with the Pharmacy Sales Director to execute market strategies for the designated market segment
• Responsible for all phases of the sales process through leads and follow-ups
• Participate In development of combined market segment and geographic plan
• Participate in identifying the profile of clinics that can most benefit from a relationship with Lumicera and the market research to identify those that are best aligned to the profile
• Internal sales project team leadership
• Identify, manage discovery and presentation of solution, and negotiation
• Report Sales Activities to Pharmacy Sales Director with respect to: Sales Pipeline, Status of projects and ‘cases’, Prospective clinic strategies, and Assessment of other market team efforts
• Travel to regional prospective clinic sites up to 60% of time
• Participate in business events, conferences, trade shows and seminars, supporting our marketing efforts as needed
• Other duties as assigned

Senior Pharmacy Sales Representative, Orange County/County of San Diego

Pharmacist

• Develop and deliver follow up messages to physicians and members related to prior authorization and high cost case management case documentation
• Manage queues for pharmacy technician related work for prior authorization, high cost cases, claims editing and clinical policy processes
• Perform prior authorization case management related to administrative denial and low-clinical acuity cases as identified by clinical policies and guidelines.

Pharmacy Technician – Utilization Management

• Lead negotiation of pharmacy participation agreements across all provider segments, including national chains, grocers, PSAOs, and independent pharmacy networks.
• Own reimbursement structures, contract terms, and financial outcomes of pharmacy provider agreements.
• Establish negotiation strategies that balance market competitiveness with enterprise financial and network performance goals.
• Serve as the decision-maker for contract structure, rate positioning, and escalated negotiation decisions.
• Approve contract exceptions and ensure alignment to broader network strategy and pricing objectives.
• Provide strategic leadership over pharmacy participation agreements, network addenda, and contract standards, ensuring consistency with enterprise pricing, access, and compliance objectives.
• Develop and maintain contracting playbooks, standards, and governance frameworks to support scalable and consistent negotiation practices.
• Guide contract structure decisions to support evolving pricing strategies, regulatory changes, and market dynamics.
• Lead provider engagement strategy to support successful contract negotiations, alignment to contract intent, and long-term network stability.
• Ensure negotiated contract terms are clearly defined, documented, and positioned for accurate downstream implementation.
• Partner with Network Operations and Performance teams to support effective handoff, implementation, and validation of contract terms.
• Act as escalation point for complex, high-risk, or systemic contract issues requiring higher-level leadership intervention.

Director, PBM Pharmacy Network Contracting

Director

• Provide strategic leadership over pharmacy participation agreements, network addenda, and contract standards, ensuring consistency with enterprise pricing, quality, and access strategies.
• Develop and maintain contracting playbooks, standards, and governance frameworks to guide negotiations, amendments, and operational application.
• Partner with Legal, Compliance, and Network Pricing leadership to ensure contract structures align with regulatory requirements and enterprise objectives.
• Support strategic contract amendments, renewals, and enhancements, focusing on intent, scalability, and long‑term impact, rather than transactional execution.
• Serve as a senior point of engagement for pharmacy providers, chains, and affiliations on contract‑related matters.
• Maintain productive, professional relationships with providers to support alignment, transparency, and issue prevention.
• Lead provider discussions related to contract interpretation, structural changes, and strategic alignment, escalating only high‑impact or systemic issues.
• Partner with Provider Services and Network Leadership to ensure consistent provider messaging and engagement models.
• Provide strategic guidance on contract interpretation to support pricing strategy, claims configuration, and network governance.
• Act as an escalation point for complex, high‑risk, or systemic contract issues, while ensuring routine transaction‑level issues are handled operationally.
• Analyze trends in provider inquiries or disputes to identify structural contract or process improvement opportunities.
• Recommend contract language, governance, or system changes to reduce recurring operational friction.
• Support Sales and Client Services by providing strategic clarity on contract constructs and network positioning.
• Participate in company initiatives related to network strategy, growth, and regulatory readiness.
• Provide leadership and direction to contract strategy, governance, or senior contract staff, as applicable.
• Set expectations for quality, consistency, documentation, and escalation discipline.

Director, PBM Contract Strategy – Engagement

Accountant

• Prepare, review and post journal entries
• Maintain and monitor general ledger account reconciliations; investigate and resolve reconciling differences
• Prepare inventory related journal entries and perform monthly inventory reconciliations
• Review inventory variances to ensure accuracy and limit financial burden
• Analyze inventory discrepancies and provide metrics to leadership
• Reconcile intercompany account balances and prepare journal entries and bank transfers as needed for assigned entities
• Prepare and assist with audit and tax requests from external consultants
• Perform new client and vendor set up as requested. Ensuring accurate updates are made to existing clients and vendors.
• During month-end financial closing, analyze monthly financial statements and reports and perform variance analysis on revenue, expense, and balance sheet-related accounts
• Prepare and review accounting schedules for leases and prepaids to ensure accuracy against signed agreements and invoices received
• Assess depreciation and amortization schedules and collaborate with other internal departments to manage and record fixed asset expenditures.
• Identify and account for all asset transfers and disposals. Generate and evaluate depreciation reports for financial and tax reporting and distribute reports to internal and external stakeholders.
• Analyze reports from the Navitus billing system to ensure client billing is accurate. Generate and send invoices. Prepare manual billings when needed.
• Monitor daily bank account activity and ensure cash transactions are recorded timely and accurately. Analyze and research customer accounts for accuracy and identify past due balances.
• Run unclaimed property reports and generate letters required by each state. Research requirements for each state and ensure compliance
• Process ACH payments for clients consistent with payment terms

Accountant II

Engineering Manager

• Own end-to-end delivery of software developed by the POD, ensuring timely releases that meet agreed-upon business requirements and quality standards.
• Partner with business owners to define priorities, clarify requirements, and align deliverables with strategic objectives.
• Monitor progress against commitments, proactively addressing risks, dependencies, and resources constraints.
• Ensure that solutions are scalable, secure, and reliable leveraging best practices / patterns / standards of design and architecture.
• Lead, mentor, and inspire the POD team, fostering a culture of accountability, collaboration, and continuous improvement (through experimentation and learning).
• Manage staffing; including recruitment, performance management, and professional development for direct and dotted-line resources.
• Drive adoption of CI/CD pipelines, DevOps practices, and automated testing to maintain high-quality releases.
• Provide technical coaching and professional development opportunities for team members to enhance their skills, knowledge, and career growth.
• Serve as the primary liaison between the POD and business stakeholders when there are escalations from the product owner (or team).
• Proactively collaborate with other development managers to resolve cross-team dependencies and maintain alignment with enterprise technology strategy.

Manager, Software Development

Sales

• Act as the point of contact for new business and assist Sales with entering information regarding the opportunity into CRM.
• Assist with the qualification of opportunities, including direct contact with advisor, broker, and/or consultant partners with existing and new firms.
• Review incoming RFP materials, including qualitative and quantitative data for completeness, and communicate to Director, Market VP Sales & Market Strategy and other team members.
• Work closely with Director of Sales Marketing, Analytics, and Account Management to help prioritize and ensure the timely production and delivery of sales materials.
• Monitor drug trends and margin analysis to provide insight to Market VP Sales on opportunities for business improvements.
• Develop content for lead-generation campaigns, emails, collateral, blogs, articles, social media, presentations and other materials.
• Compile competitive intelligence and conduct market research as needed.
• Understand the capabilities, tools and positioning of the competitive landscape.
• Act as first line of contact for incoming calls/emails from brokers/advisors/consultants when appropriate.
• Track and submit intent to bid.
• Undergo training on repricing tool and other RFP analytics over time to assume greater responsibility.
• Prepare finalist meeting materials.
• Develop and maintain checklists and processes to efficiently intake and respond to a high-volume of incoming requests.
• Manage various CRM pipeline reports for Sales and other leadership as well as prepare presentations, presentation slides and documents, and presentation support materials.
• Type memos, compile documents, and support leadership with agendas, scheduling meetings, minutes and other memorandums.
• Other duties as assigned.

Sales Analyst

• Provide strategic leadership over pharmacy participation agreements, network addenda, and contract standards, ensuring consistency with enterprise pricing, quality, and access strategies.
• Develop and maintain contracting playbooks, standards, and governance frameworks to guide negotiations, amendments, and operational application.
• Partner with Legal, Compliance, and Network Pricing leadership to ensure contract structures align with regulatory requirements and enterprise objectives.
• Support strategic contract amendments, renewals, and enhancements, focusing on intent, scalability, and long‑term impact, rather than transactional execution.
• Serve as a senior point of engagement for pharmacy providers, chains, and affiliations on contract‑related matters.
• Maintain productive, professional relationships with providers to support alignment, transparency, and issue prevention.
• Lead provider discussions related to contract interpretation, structural changes, and strategic alignment, escalating only high‑impact or systemic issues.
• Partner with Provider Services and Network Leadership to ensure consistent provider messaging and engagement models.
• Provide strategic guidance on contract interpretation to support pricing strategy, claims configuration, and network governance.
• Act as an escalation point for complex, high‑risk, or systemic contract issues, while ensuring routine transaction‑level issues are handled operationally.
• Analyze trends in provider inquiries or disputes to identify structural contract or process improvement opportunities.
• Recommend contract language, governance, or system changes to reduce recurring operational friction.
• Support Sales and Client Services by providing strategic clarity on contract constructs and network positioning.
• Participate in company initiatives related to network strategy, growth, and regulatory readiness.
• Provide leadership and direction to contract strategy, governance, or senior contract staff, as applicable.
• Set expectations for quality, consistency, documentation, and escalation discipline.
• Other duties as assigned.

Director, Contract Strategy – Provider Engagement

Operations

• Perform the daily, weekly, and monthly/periodic administrative functions necessary to update and maintain the formularies for Navitus’ clients for all lines of business
• Work with the Formulary Services Supervisors to make all changes to the formulary information accessed by clients
• Day to day formulary maintenance
• Having advisory input to how this information is presented, maintained, and reviewed
• Take formulary information from various sources including the Pharmacy and Therapeutics Committee, the Formulary Advisory Committee, and Clinical Account Executives to coordinate the process of entering the information into the formulary change database and communicating changes to Benefits Systems and Auditing
• Maintain up-to-date formulary documents available through multiple resources including ePocrates, web portals, and e-prescribing
• Review weekly Medispan Reports for new drugs and drug changes that impact the formulary
• Collaborate with clinical and client services throughout new client implementations to capture the formulary information needed for plan set-up
• Trouble-shoot various formulary/set-up questions
• Approximate travel required (5-10%)
• Other duties as assigned

Specialist, Formulary Operations

Client Services Representative

• Delegate, support and provide guidance to colleagues in Senior CSC and CSC roles
• Pull data from 3-D and other Navi-tools to deliver facts-based presentations (including Strategic Business Plans, VALUE Summaries, and Performance Standard reports) to clients.
• Work closely with Clinical Account Executive on data, strategy, and the Navitus team approach to all meetings
• Ensure immediate Client Services team has a plan to mediate any unmet PGs moving forward; Client Services should always have a debrief with an internal department which has failed to meet a PG
• Client Services Executive should be able to perform both basic training and specialized training on client-facing platforms, as long as the client has placed this request ahead of time
• Facilitate resolution of escalated member/Client issues requests
• Manage Clients Contract maintenance and performance
• Travel to Client sites
• Provide mentoring to the coordinator levels
• Other duties as assigned

Client Services Executive

• Schedule and monitor staff and day to day workflow.
• Develop employee’s skills, evaluate performance, and provide feedback.
• Oversees resolution of employee relations.
• Participate in hiring, training, and evaluation of staff
• Develop, track, and monitor employee’s compliance to quality, service, and production standards
• Monitor task turnaround time so that internal standards and client performance guarantees are met
• Assist Associate Manager, Pharmacy Services in monitoring costs to ensure compliance with cost goals
• Address staff concerns and day to day operational, system, customer service, quality, and professional issues
• Work in production as needed
• Implement programs and process improvements to enhance the level of internal and external customer service provided.
• Work with Associate Mgr., Pharmacy Services to analyze operations and overall efficiencies of the pharmacy
• Work as a point of escalation for issues requiring a higher degree of expertise or discretion to resolve.
• Represents pharmacy operations and service in cross-functional meeting and projects
• Participate in continued quality improvement and quality meetings as necessary
• Other duties as assigned

Supervisor, Specialty Pharmacy Support Service

Artificial Intelligence

• Design, build, and maintain enterprise AI solutions and services that enable the scalable adoption of generative AI, machine learning, and agentic AI capabilities across the organization.
• Implement enterprise AI architecture patterns and technical standards defined by the Enterprise AI Architect, translating reference architectures and design patterns into production-ready solutions.
• Develop and support AI integration patterns that connect AI capabilities with enterprise applications, APIs, data platforms, and cloud services.
• Build and maintain AI-enabled services and components, including model interfaces, orchestration services, agent frameworks, and reusable AI tooling for enterprise teams.
• Support the implementation of Agentic AI workflows, including orchestration, tool integration, context management, and human-in-the-loop capabilities.
• Implement and maintain AI operational capabilities (MLOps/LLMOps) including model deployment pipelines, monitoring, observability, lifecycle management, and operational controls.
• Ensure AI solutions align with enterprise AI governance, responsible AI standards, and regulatory requirements, including data privacy, auditability, and model transparency.
• Support AI platform development and enablement, working with Platform Engineering and Data Engineering teams to deploy, scale, and maintain enterprise AI infrastructure and tooling.
• Other duties as assigned.

Engineer, Enterprise AI

• Lead end ‑ to ‑ end negotiations with wholesalers, distributors, and suppliers to secure competitive pricing, favorable terms, and reliable access for GPO member pharmacies.
• Manage and maintain all wholesaler contracts to ensure negotiated pricing is accurately extended to eligible member pharmacies.
• Proactively evaluate opportunities to expand savings, improve contract structures, and enhance partner value.
• Develop and execute strategies to optimize primary and secondary wholesaler arrangements for GPO partners.
• Lead RFP processes for wholesaler and supplier negotiations, including comparative financial analyses and performance assessments.
• Drive continuous improvement in wholesale channel performance, pricing competitiveness, and operational effectiveness.
• Build and maintain strong, collaborative relationships with wholesalers, distributors, and suppliers.
• Serve as the primary point of contact for strategic alignment, escalation, performance discussions, and partnership development.
• Actively monitor supplier performance and promote accountability to contract terms and service expectations.
• Negotiate agreements with GPO member pharmacies covering drug access requirements, data ‑ sharing expectations, utilization reporting, and administrative fees.
• Ensure consistent communication to pharmacy partners regarding contract terms, pricing changes, and compliance requirements.
• Ensure all wholesaler, supplier, and pharmacy agreements align with legal, regulatory, and industry standards, including anti ‑ kickback, transparency, and reporting requirements.
• Partner with Legal to develop, refine, and maintain contract templates, SLAs, and audit protocols.
• Collaborate with internal analytics, finance, and operations teams to leverage data for pricing analysis, forecasting, and contract performance monitoring.
• Use financial modeling to support negotiation strategies and inform organizational decision ‑ Analyze the financial implications of wholesaler contracts and pricing models to maximize member savings and organizational profitability.
• Deliver reports that support GPO economic value assessments and budget planning.
• Work closely with finance, legal, operations, supply chain, analytics, and member engagement teams to ensure alignment and execution of contracting strategies.
• Maintain accuracy and integrity in reporting workflows, pricing files, and GPO partner documentation.
• Lead and inspire high-performing teams by providing strategic direction, aligning talent and resources with organizational goals to drive operational excellence, foster cross-functional collaboration, and promote a culture of continuous improvement across key business initiatives.
• Willingness to travel up to 10% of the time to support business needs.

Director, Trade Negotiations and Contracting

• Request historical files from advisor or client, and review layout as needed.
• Host the TPA implementation meetings.
• Review data transmission process, file layouts, timing, etc..
• Determine system hierarchy requirements and build in CRM.
• Coordinate eligibility test files, updates, and production.
• Coordinate claims extracts with all vendors (TPA, stop loss, advisor).
• Coordinate ID card from TPA for approval.
• Validate eligibility files and extracts post go live.
• Conduit to the Navitus eligibility and claims extract teams.
• Manage data sharing policies and Non-Disclosure Agreements with vendors.
• Submit data and service requests, and ongoing monitoring to ensure accurate, timely completion.
• Troubleshoot any vendor issues to ensure quick resolution, including support of the account teams in helping to facilitate resolution of escalated file issues.
• Suggest and implement new vendor management processes, policies, and methods as needed.
• Identify and research expansion opportunities, in addition to the growing the client base with existing consultant/broker/TPA relationships.
• Other duties as assigned.

Vendor Manager, Client Operations

Vice President

• Own and lead Navitus’ Group Purchasing Organization (GPO) strategy and administration, including governance, performance management, compliance oversight, and alignment with Navitus’ rebate and contracting objectives.
• Establish and execute an enterprise rebate strategy that balances market competitiveness, clinical integrity, transparency, and lowest net cost outcomes for clients.
• Lead senior ‑ level pharmaceutical manufacturer negotiations and strategic engagements, ensuring contracts, rebate structures, and guarantees align with Navitus ’ long ‑ term strategy, financial objectives, and client commitments.
• Partner with executive peers across Clinical Services, Provider Services, Sales, Pricing, Finance, Compliance, and Analytics to ensure integrated strategy execution.
• Provide executive counsel on pharmaceutical industry trends, rebate strategy implications, and market risks/opportunities.
• Provide executive oversight for rebate and contracting analytics, including market assessment, financial modeling, pricing support, and guarantee development.
• Partner with Sales, Pricing, and Finance to translate rebate and contracting strategy into competitive, compliant, and defensible pricing approaches for current and prospective clients.
• Oversee rebate financial structures, performance programs, and reimbursement mechanisms associated with manufacturer and GPO agreements.
• Ensure robust contract interpretation, issue resolution, and escalation governance for rebate ‑ related matters across the enterprise.
• Establish analytics standards and insights that clearly articulate the value of Navitus’ contracting, rebate, and formulary strategies to clients and consultants.
• Monitor pharmaceutical market dynamics, competitive trends, pipeline developments, and regulatory activity to proactively inform strategy and positioning.
• Serve as executive owner of the Formulary Advisory Committee responsible for ownership of formulary financial performance.
• Through partnership with Clinical Services leadership, ensure formulary recommendations are grounded in clinical evidence, market intelligence, client impact, and rebate considerations while maintaining independence and transparency.
• Set standards for formulary governance, documentation, and decision rationale; ensure alignment with compliance expectations and Navitus’ clinical philosophy.
• Partner with Clinical Services leadership to ensure clear separation between formulary governance and operational execution, while maintaining strong strategic alignment.
• Maintain an active presence in industry forums, conferences, and working groups to enhance Navitus’ visibility, credibility, and influence.
• Act as a senior external representative for Navitus with pharmaceutical manufacturers, industry organizations, coalitions, consultants, and key stakeholders.
• Build and lead high ‑ performing teams focused on strategy, analytics, governance, and manufacturer engagement.
• Establish, mentor and develop team members through coaching, feedback, and career planning, ensuring a pipeline of future leaders and a culture of accountability and growth.
• Bring forward emerging industry insights, regulatory developments, and innovation opportunities to executive leadership.
• Ensure all activities adhere to Navitus’ compliance program, ethical standards, and regulatory obligations.
• Participate in, adhere to, and support compliance, people and culture, and learning programs.
• Perform other duties as assigned.