The Manager, Government Clinical Services provides strategic vision and operational oversight of the department as well as direct management and leadership of clinical staff within the department. The Manager ensures prompt program execution, presents products to external and internal clients, and drives results in support of the corporate strategic plan. The Manager will have responsibility for the required clinical services and for driving outcome analysis initiatives to completion. The Manager, in coordination with the Program Manager of Government Clinical Services, oversees duties related to the development, implementation, outcomes reporting, and ongoing administration of Navitus’ clinical programs, reports, and edits for Medicare and Medicaid populations while fostering a collaborative and cohesive team culture.

 

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• 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. 

• 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 Medicaid and Medicare 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 Customer Care, Customer Success, and other internal customers in responding to and resolving pharmacy-related inquiries from Medicaid and Medicare members, clients, providers, or pharmacies.

• Assist the Residency Program Director with the accredited PGY1 Managed Care Residency Program.

• Assist the Customer Success, Implementation, and Government Programs teams with new Medicaid and Medicare implementations and with annual re-implementations, including support of the transition process to ensure clinical and operational functionality.

• Other duties as assigned 

• Bachelor’s degree in pharmacy or Pharm D required.

• 5 years clinical experience, or clinical/managed care pharmacy practice residency plus three years clinical experience required.

• Knowledge of PBM industry, formulary management, clinical outcomes research, pharmacy claims, and managed care principles and practices desired. 

• Participate in, adhere to, and support compliance program objectives 

• The ability to consistently interact cooperatively and respectfully with other employees