Navitus Health Solutions

Content Marketing Manager

• Primary administration and integration within our SaaS Enterprise Content Management (Document/Workflow) Suite
• Ensure all environments are managed and maintained to meet service level agreements
• Implement Security measures and access controls
• Support change control and testing processes for modifications to application systems
• Analyze system for overall performance and give recommendations for improvements
• Provide responsive technical assistance and document configuration to support processes
• Develop strong working relationships with third party vendors
• Research and recommend innovative, and where possible automated approaches for system administration tasks
• Identify approaches that leverage our resources and provide economies of scale
• Quick, efficient, and effective issue resolution with proactive communication to all stakeholders
• Recommend, schedule, and perform improvements, patches, and reconfigurations
• Develop, document, and maintain policies, procedures and associated training plans for system administration and appropriate use
• Work with additional functional teams to ensure optimal operations and uptime of application environments
• Proactive monitoring and maintenance of SaaS / Windows system environments
• Provide backup administration support to other teammates
• Provide after-hours support

Administrator II, Enterprise Content Management

Pharmacist

• Make decisions regarding the resolution of pharmacy issues
• Establish and maintain contracts with pharmacy providers
• Facilitate submittal, receipt, tracking, and process flow of contracts between Navitus and providers
• Accurately enter information and maintain contract database
• Generate reports on network performance to monitor the claims accuracy throughout the terms of the contract
• Responsible for creating networks based on the contract terms within the claims processing system and ensure accuracy with performing quality reviews
• Assists in resolving intricate pharmacy provider issues and complaints
• Coordinate pharmacy network communication efforts including collection of content, disseminating information to provider partners through appropriate channels, and tracking response metrics
• Other duties as assigned

Pharmacy Relations Specialist

Account Manager

• Own and advance company scale growth initiatives aligned with Archimedes’ long-term strategy
• Lead opportunities characterized by complexity, ambiguity, and high strategic value, including multiyear or multi-party partnerships
• Partner closely with the SVP, Chief Growth Officer to prioritize, structure, and execute the organization’s most critical growth efforts
• Convert complex market needs into actionable growth strategies that leverage Archimedes’ clinical and analytics differentiation
• Build and manage C suite and senior executive relationships across strategic customers and partners
• Serve as a trusted advisor to external leaders addressing healthcare affordability, outcomes, and performance challenges
• Lead executive level discussions spanning strategy, economics, outcomes, and long-term partnership value
• Represent Archimedes externally as a thought partner in advanced analytics, clinical programs, and population health
• Collaborate with product, clinical, analytics, and operational leaders to shape differentiated, partner driven solutions
• Translate customer insight and market intelligence into product roadmap recommendations and solution designs
• Support development of business cases, value models, and outcome narratives for complex opportunities
• Balance customization with scalability to ensure long term growth impact
• Lead complex sales cycles from early strategy through contract execution
• Oversee discovery, solution design, proposals, finalist presentations, and negotiations
• Drive alignment across sales, legal, finance, compliance, and implementation teams
• Maintain disciplined pipeline visibility and executive level reporting on progress, risk, and expected impact
• Act as a senior leader within the growth organization, influencing priorities without direct line authority
• Provide guidance on complex deal strategy, executive engagement, and partnership structuring
• Promote collaboration, accountability, and strategic rigor across teams
• Foster a collaborative environment by sharing knowledge and experience to build expertise in others
• Provide guidance and leadership to direct reports and other team members to achieve aligned results
• Lead and inspire high-performing teams by providing strategic direction, aligning talent and resources with organizational goals, and driving operational excellence across key initiatives
• Mentor and develop team members through coaching, feedback, and career planning, building a strong pipeline of future leaders and supporting professional growth
• Participate in, adhere to, and support compliance, people and culture, and learning programs
• Perform other duties as assigned

Senior Director, Strategic Growth Partnerships

• Perform packaging and shipping duties based upon established protocols that take medication storage requirements and final shipping destination into account.
• Assist in the receipt and stocking of pharmaceuticals and supplies within the pharmacy.
• Demonstrate flexibility in scheduling and the capacity to work overtime as required.
• Act in accordance with all applicable federal and state laws and with the highest ethical standards that we consistently strive to achieve.
• Other duties as assigned.

Fulfillment Specialist, Specialty Pharmacy

Content Writer

• Support Navitus' client acquisition and retention efforts by drafting responses to Requests for Proposals (RFPs) and other sales-related documents for a variety of client audiences
• Sales support activities can include project coordination (e.g., planning, scheduling, organizing, and coordination), follow-up correspondence, and reporting
• Utilize expert-level editorial, grammatical, and writing skills to ensure all written deliverables follow and demonstrate tactical, strategic, financial, and sales-capture decisions
• Proficiently understand and continuously develop knowledge of business units target markets and trends in those markets and how the products and services are/or may be utilized in the target markets
• Utilize strong project management skills to initiate, collect and deliver on analytical tasks in collaboration with cross-functional SMEs
• Demonstrate an attention to detail and strong time management skills by developing and adhering to stringent timelines
• Support proposal content management and department processes to keep materials current and competitive
• Contribute to the department goal of improved efficiency and effectiveness, including identifying and providing insights into streamlining departmental processes
• Other duties as assigned

Proposal Writer

• Provide patient education through telephonic consultations for patients of the specialty pharmacy in accordance with Lumicera’s Patient Management Program.
• The consultations will focus on effective assessment and communication of disease state management, side effect mitigation strategies, administration of medication, appropriate storage, and therapeutic appropriateness, following patient-centered care model.
• Answer clinical questions from patients and caregivers.
• Provide detailed clinical documentation of patient consultations and interventions in pharmacy software system in compliance with internal policies and procedures and external regulatory bodies (such as URAC).
• Contact physicians for new prescriptions, consult with physicians and nurses regarding pharmaceutical questions, and contact pharmacies for prescription transfers.
• Work with physicians to convert prescriptions to generic, biosimilar, or preferred drugs whenever possible.
• Conduct evidence-based research and interpret clinical data in support of Lumicera’s clinical outcomes research program.
• Act in accordance with all applicable federal and state laws and with the highest ethical standards.
• Thus, legal and ethical compliance is an essential duty of each employee.
• Document and report medication errors per company policies and procedures.
• Facilitate error reduction and prevention methods based on quality department and ISMP standards.
• Adapt to new workflows and processes.
• Solve unique pharmaceutical problems.
• Stay current with advancements in specialty pharmacy therapies, including new drug approvals and specialty disease state treatment guidelines.
• Participate in training, workshops, and mentoring opportunities as assigned to expand knowledge.
• Participate in, adhere to and support compliance and diversity, equity, and inclusion program objectives.
• Other duties as assigned.

Clinical Intern, Specialty Pharmacy

• Initiate prescription prior authorizations on behalf of prescriber’s offices
• Coordinate and confirm with patients’ prescription deliveries
• Initiate contact and create new potential clinic/prescriber relationships
• Communicate current and relevant prescription, insurance and financial needs as they relate to appropriate pharmacists, providers, clinical support staff and patients
• Interacts with clinic employees, including but not limited to pharmacists, clinical staff, fiscal personnel, department managers, access services staff, coding staff, and billing assistants
• The Employee will act in accordance with all applicable federal and state laws and with the highest ethical standards that we consistently strive to achieve
• Serves as the liaison between the medical staff, outpatient pharmacies, insurance providers and patients to improve communication and continuity of care
• Other duties as assigned

Referral Coordinator, Specialty Pharmacy

• Responsible for answering the inbound calls from patients, prescribers, and other healthcare professionals
• Responsible for contacting doctors to obtain necessary prescription information to properly fill a prescription
• Responsible for managing the queues and working oldest orders first
• Responsible for the correct shipment of the specialty pharmacy orders
• May be responsible for ensuring adequate inventory of pharmaceuticals in the pharmacy, including ordering, receipt, verification of orders, and stocking of pharmaceuticals and supplies
• The Employee will act in accordance with all applicable federal and state laws and with the highest ethical standards that we consistently strive to achieve.

Pharmacy Technician I

• Responsible for support and input to clinical programs such as: Health Management, Drug Utilization Review, Formulary development, and Prior Authorization programs to encourage appropriate, high quality, cost effective drug therapy; and to identify opportunities for improvement in efficiency, accuracy, and appropriateness of the programs in place
• Participate in the Coverage Determination (Certification, Prior Authorization, Medical Exception, Exception to Coverage, etc.) process by reviewing all requests which are not clearly approvable based on specified criteria (algorithms), making all coverage denial determinations, and identifying themselves by first name, title, and responsibility at Navitus in relation to drug utilization management program administration
• Continually monitor the quality and efficiency of the Coverage Determination process including coverage criteria, denial language, and communication with prescribers
• Provide input to clinical content of new programs and for maintenance of existing programs
• Complete all annual URAC training requirements
• Facilitation of communication and education to clients, members, and internal staff regarding clinical daily issues and objectives
• Provide support to operational departments on the implementation of various PBM programs and daily functioning in support of member/patient quality of care
• Responsible for supporting / providing clinical expertise related to formulary decisions made by the Pharmacy and Therapeutics committee
• May review health care survey data for Medicare Part D qualified participants and/or perform phone consultations with Med-D enrollees; aid in documentation of calls; designate enrollees for repeat interaction
• Other duties as assigned

Pharmacist I – Clinical Prior Authorization

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.

Senior Manager, Population Health

Call Center Representative

• Lead operational redesign and define business strategies that improve service performance, scalability, and operational efficiency across Customer Care.
• Establish and oversee integrated staffing models, cross-training strategies, and operational workflows across Customer Care, including PA Intake, specialized teams, and customer communications.
• Partner with IT leadership to ensure Customer Care systems and applications effectively support operations, analytics, and reporting, with ongoing evaluation to optimize performance and scalability.
• Serve as the accountable business owner for company customer and member experience initiatives, providing end-to-end leadership from strategy development and innovation through execution, adoption, and sustained results.
• Define performance standards, service metrics, and operating benchmarks to drive accountability and consistently exceed service-level expectations.
• Establish strong cross-functional working relationships between Customer Success, Clinical Services, Technical Operations, and Government Programs, Sales and Implementation departments to ensure seamless service delivery and client onboarding.
• Provide strategic oversight of Customer Care workforce planning, forecasting, and capacity modeling by analyzing demand trends, developing forecasts, researching business requirements, workflow design, and business growth requirements.
• Lead forward-looking strategy and the adoption of innovative methodologies to continuously enhance call center capabilities, operational performance, and technology advancement.
• Drive a culture of continuous operational improvements focused on enhancing customer experience, operational effectiveness, and quality outcomes.
• Set strategic direction for associate training, leadership development, and call center certification to ensure workforce readiness and performance excellence.
• Evaluate emerging technologies, systems, and sourcing strategies to strengthen Customer Care capabilities and improve serve delivery.
• Oversee the development, implementation, and governance of Customer care policies, procedures, and quality frameworks, including performance monitoring and corrective action.
• Ensure robust tracking, trending, and reporting of operational metrics, performance guarantees, and service outcomes.
• Provide oversight of accreditation, including application preparation, compliance maintenance of necessary documentation to demonstrate compliance with accreditation standards and coordination of on-site reviews.