Navitus Health Solutions is seeking a Market VP, Sales to join our team!   The Market VP, Sales will manage the entire scope of the sales process for new Navitus Health Solutions National Accounts business in the following markets: Employer, Government, Labor (municipal, Taft-Hartley), and Self-funded companies. The Market VP, Sales will work with Executive Sales leadership to develop and execute market strategies for these market segments. The Market VP, Sales is responsible for all phases of the sales process through finalist presentation and signed contract....

Archimedes is a specialty drug management company with industry-leading technology and services that health plans and employer groups can use to manage specialty drug spend. We are expanding our team and looking for a clinical professional who has specialty drug management experience and a passion for cost management. Given our continued growth trajectory, we are looking for a person who can grow with the company.   This role will be divided into two areas: external clinical outreach activities related to high-cost case management and prior authorization of specialty medications, across pharmacy and medical benefits and specialty and traditional drugs. In...

Navitus Health Solutions is seeking a Supervisor, Clinical Engagement Center (RPh) to join our team!   The Supervisor, Clinical Engagement Center (RPh) is responsible for leadership and support of a cross functional team of associates within the CEC.  This role will also have expanded responsibility for select clinical functions as assigned by their manager. This may include, but is not limited to, quality improvement initiatives, auditing, creation and maintenance of detailed work instructions, new program development, collaboration with additional Navitus teams...

Navitus Health Solutions is seeking a Supervisor, Claim Adjudication Operations to join our CAO Client department!   The Supervisor, Claim Adjudication Operations ensures the streamlined operation of the Claim Adjudication Operations team in alignment with customer-focused objectives. This individual will plan, design, coordinate and align resources to support the daily activities of the team. The supervisor will work closely with their team to identify, recommend, develop, implement, support, and improve customer-focused solutions.

Archimedes is a specialty drug management company with an industry-leading technology platform that health plans and employer groups can use to manage specialty drug spend. We are expanding our team and looking for a self-motivated project management professional who has specialty drug management experience and a passion for cost management. Given our continued growth trajectory, we are looking for a motivated project manager who can grow with the company to buildout and lead large projects. The successful candidate will work directly with clients to ensure deliverables fall within the applicable scope, timing and budget. We are looking for a creative and dedicated individual who will fit with...

Archimedes is a specialty drug management company with an industry-leading technology platform that health plans and employer groups can use to manage specialty drug spend. We are expanding our team and looking for a self-motivated project management professional who has specialty drug management experience and a passion for cost management. Given our continued growth trajectory, we are looking for a motivated project manager who can grow with the company to buildout and lead large projects. The successful candidate will work directly with clients to ensure deliverables fall within the applicable scope, timing and budget. We are looking for a creative and dedicated individual who will fit with...

The Analyst, Customer Experience ensures efforts are in alignment with our customer focused efforts within the CX/DX department. The Analyst, Customer Experience will help envision, design, and create prototypes of positive customer interactions. Journey maps, ideation, and other facilitated events to enhance customer experience will be led by this role. Identifying and serving key stakeholders is critical to this role. The Analyst, Customer Experience will utilize their technical competency to facilitate prototyping activity.   Is this you? Find out more below!

Navitus Health Solutions is seeking a Sr. Proposal Analyst to join our Proposal Department!   The Sr. Analyst, Proposal role is critical to the client acquisition and retention efforts of Navitus Health Solutions. This position works cross-functionally at a variety of levels to maximize sales and retention through the timely creation and management of competitive responses to Requests for Proposals (RFPs) and other sales related documents for a variety of audiences. The Sr. Analyst, Proposal ensures agreed upon strategies are incorporated into persuasive,...

Navitus Health Solutions is seeking a Sr. Solutions Architect to join our IT Development team!   The Sr. Solutions Architect ensures efforts are in alignment with the IT FFS (Fee for Service) Medicaid Technology team to support customer-focused objectives and the IT Vision: a collaborative partner delivering innovative ideas, solutions, and services to simplify people’s lives. The Sr. Solutions Architect is responsible for driving the software architecture and platform of our AWS Cloud-based ecosystem. The Sr. Solutions Architect will define the technical end-to-end architectures needed to support the strategic direction of the FFS Medicaid line of business.   Is...

Lumicera Health Services is seeking a Pharmacy Technician to join our Specialty Pharmacy Operations team!   Under direction from the Pharmacist-in-Charge and other pharmacists in the Specialty Pharmacy, the Pharmacy Technician I is primarily responsible for assisting the pharmacist in obtaining all the necessary information for dispensing and adjudicating a medication correctly. The Pharmacy Technician I’s main objective is to answer phone calls and contact the doctors and patients via fax or phone or other communication means. The Pharmacy Technician I is also responsible for accurately translating prescription information and all other information obtained to dispense the...

Navitus Health Solutions is seeking a Software Engineer to join our IT Development department!   The Software Engineer position ensures efforts are in alignment with the Information Technology team, to support customer-focused objectives and the IT Vision, a collaborative partner delivering innovative ideas, solutions, and services to simplify people's lives. They will serve in a more seasoned capacity, within the team and will collaborate with the business teams to prototype new technologies and recommend solutions. This role will be involved with research,...

Archimedes is a specialty medical management company with an industry-leading technology platform that client groups can use to manage specialty medical spend. This position is responsible for training program design, development, planning, and facilitation for call center operations. The creation of comprehensive learning and development programs that meet the specific needs of the organization. This position acts as a Liaison between product development and the call center operations team for training and UAT testing, and a liaison with the Account Management for mutual understanding of call center processes and issues.

Archimedes is a rapidly growing leader in the specialty drug benefit management space.  We are looking for a Member Services Representative to work on-site in our Brentwood, TN office.  This position is responsible for delivering excellent service to members utilizing processes and technology within a call center.  If you are reliable with strong problem-solving and customer service skills, we would love to hear from you

Navitus Health Solutions is seeking a SIU Analyst I to join our team!   The SIU Analyst position is responsible for conducting moderate to complex research using internal and external databases to perform analyses and develop recommendations on suspected fraud, waste, and abuse related to members, prescribers, pharmacies, and clients. In addition, the Analyst is responsible for regular and proactive extraction and evaluation of mined data, scoping data for investigations, and responding with reports and data for audits, universes, and impact assessments. The Analyst will coordinate and support data requests from third parties regarding fraud,...

Navitus Health Solutions is seeking a Product Owner, IT to join our IT Delivery department! The Product Owner, IT will collaborate and facilitate value delivery. The Product Owner will play a critical role in partnering with Business Leads and the Portfolio to define, prioritize, and drive the development of product enhancements and large strategic initiatives. The Product Owner will work closely with a cross functional team to ensure that the value delivery aligns with the overall business objectives and meets customer needs.  Is this you? Find out more below!  

Archimedes is a rapidly growing leader in the specialty drug benefit management space. We are looking for a Supervisor, Member Services in our Brentwood, TN location. This position will lead a team of representatives and is responsible for the overall performance of the call center. A deep understanding of Archimedes’ culture and mission is vital to the success of this position.

Under general direction of the Associate Manager, Pharmacy Services, the Supervisor, Specialty Pharmacy Support Services is responsible for managing the day-to-day operations of a team of either Reimbursement or Intake Specialists. This position monitors productivity and performance standards and plans and directs workflow and project assignments. Oversees production volume to ensure service standards are met. The Supervisor, Specialty Pharmacy Support Services will participate in hiring, training, and evaluation of staff, as well as be responsible for team’s adherence to corporate attendance and employment policies. This individual will work with the Associate Mgr, Pharmacy Service to develop policies, procedures, and the business...

Navitus Health Solutions is seeking a Clinical Prior Authorization Pharmacist to join our team!   The Pharmacist I, Clinical Prior Authorization will be responsible for: performing Prior Authorizations; perform duties related to Drug Utilization Review including concurrent, retrospective, and prospective components; and support Customer Care with clinical calls requiring pharmacist intervention. The Pharmacist I, Clinical Prior Authorization is also responsible for interfacing with physicians, pharmacists, and specialty pharmacy providers with respect to beneficiaries’ benefits and therapeutic interventions, and reviewing/evaluating the...

Due to growth, we are adding an Accumulator Coordinator to our CAO Client department.     The Coordinator, Accumulator ensures efforts are in alignment with the Claim Adjudication Operations...

Due to growth, we are adding a Supervisor, Claim Adjudication Operations to our CAO Client department.    

Due to growth, we are adding an Accumulator Analyst to our CAO Client department.     The Analyst, Accumulator ensures efforts are in alignment with the Claim Adjudication Operations (CAO) team to leverage...

Due to growth, we are adding a Coordinator, Operations Data to our CAO Implementation department. 

Navitus Health Solutions is seeking a Analyst, Tech. Operations Government Programs to join our team!   The Analyst, Tech. Operations Government Programs has responsibility for executing Government Programs processes accurately, efficiently, and in compliance with CMS regulations.   Is this you? Find out more below!

Due to growth, we are adding an Analyst, Historical Claims to our CAO Client department. 

Due to growth, we are adding a Engineer, Data Integration to our Data & Digital department.     The...

Navitus Health Solutions is seeking a Software Development Engineer in Test to join our team!   The Software Development Engineer in Test (SDET) ensures efforts are in alignment with the Strategic Technology Systems Development team to support customer-focused objectives and the IT Vision, a collaborative partner delivering innovative ideas, solutions and services to simplify people’s lives. This position will take a role in Navitus’ strategic initiatives to implement a suite of testing tools and further developing our software quality assurance expertise. This role will be responsible for learning the programming languages necessary for the utilization of the selected tools and will support...

Navitus Health Solutions is seeking a Med D Compliance Oversight Analyst to join our team!   This position is an Med D Compliance Oversight Analyst SME directly responsible for conducting internal and external audits and monitoring activities for the PBM Employer Group Waiver Program (EGWP) and MA-PD/MMP Health Plan audits. The Med D Compliance Oversight Analyst (COA) will conduct quality assurance review on all audit and monitoring results. The COA will be responsible for providing monthly/quarterly audit and monitoring reports to the internal...

Lumicera Health Services is seeking a Information Technology Manager to join our team!   The Manager, Information Technology ensures the streamlined operation of the Lumicera IT team in alignment with the customer-focused objectives and the IT Vision, a collaborative partner delivering innovative ideas, solutions, and services to simplify people’s lives. This individual will plan, design, coordinate and align resources to support the daily activities of the team. The manager will work closely with customers and decision makers to identify, recommend, develop, implement, support, and improve the customer-focused solutions.

Navitus Health Solutions is seeking s Sr. Software Developer to join our IT Development team!   The Sr. Software Developer ensures efforts are in alignment with the Information Technology team to support customer-focused objectives and the IT Vision, a collaborative partner delivering innovative ideas, solutions, and services to simplify people’s lives. The Sr. Software Developer’s role is to define, design, develop, test, analyze, and maintain new and existing applications in support of the achievement of business requirements. This includes designing, documenting, coding, testing, and analyzing software programs and applications. The Sr. Software Developer will also research, design, document,...

Navitus Health Solutions is seeking a Software Engineer to join our IT Development department!   The Software Engineer position ensures efforts are in alignment with the Information Technology team, to support customer-focused objectives and the IT Vision, a collaborative partner delivering innovative ideas, solutions, and services to simplify people's lives. They will serve in a more seasoned capacity, within the team and will collaborate with the business teams to prototype new technologies and recommend solutions. This role will be involved with research, design, development, testing and documentation of projects. They will be encouraged to...

Navitus Health Solutions is seeking a Supervisor, Prior Authorization Operations to join our Prior Authorization department!    The Supervisor, Prior Authorization Operations is responsible for organizing and supervising the daily operations of the prior authorization process and the prior authorization staff. The Supervisor, PAO is responsible for ensuring that formulary changes directed by the Pharmacy & Therapeutics Committee and changes driven...

Navitus Health Solutions is seeking a Trainer, Prior Authorization to join our team!    The Trainer, Prior Authorization Operations excels at collaborating across the organization to bring knowledge, exceptional service and build high engagement through onboarding and refresher training. This role develops and facilitates training through multiple channels and demonstrates culture and competencies for trainees so they in turn become strong performers within the Prior Authorization team and the organization. Trainer is adept at identifying training needs, creating interactive training, facilitating topics, evaluating effectiveness and...

Due to growth we are adding a Service Delivery Speacialist to our team!   Under direction from the Supervisor, Specialty Pharmacy Operations and the Pharmacist in Charge and/or Supervisor of Service Delivery, the Service Delivery Specialist is primarily responsible for the ongoing monitoring and carrier communication to help assure shipments deliver as intended. The Service Delivery Specialist’s objective is to use carrier or third-party resources at their disposal to quickly and efficiently resolve issues that may occur during shipment transit. The Service Delivery Specialist will be the primary point of contact for other members of the...

Lumicera Health Services is seeking a Specialty Pharmacy Intern to join our team!   The Specialty Pharmacy Intern will assist with customer service and clinical programs of Lumicera Specialty Pharmacy. The primary responsibility of this position is to effectively communicate with patients, physicians, pharmacists, and payers in the fulfillment and patient care of specialty pharmacy medications in a Specialty Pharmacy. Additionally, this person must have the ability to assess patient needs, consult on specialty pharmaceuticals and disease states, accurately set up orders and needed medication supplies. This role focuses on the clinical management...

Navitus Health Solutions is seeking an Analyst, Benefit Configuration to join our team!   The Analyst, Benefit Configuration ensures efforts are in alignment with the Claim Adjudication Operations (CAO) team to leverage technology and process improvement for the purpose of meeting the business needs of Navitus customers, clients, members, and pharmacies by accurately administering benefits. The Analyst, Benefit Configuration configures benefits in the claim adjudication system based on specifications from internal customers and external clients. This role applies knowledge of highly diverse plan designs, formularies, and networks across multiple lines of business, ensuring that claims adjudicate accurately and...

Lumicera Health Services is seeking a Clinical Operations Pharmacist to join our team!   The Pharmacist, Clinical Operations will be responsible for performing telephonic consultations with patients regarding the use of their specialty medication and management of their disease state. They will perform medication reconciliation, screen for potential drug interactions, and provide side effect management recommendations. Another main duty of this role will include a high volume of product verification to ensure accuracy of orders prior to shipment. The Pharmacist, Clinical Operations can expect to interpret prescribers’ prescriptions, contact prescribers and/or patients to verify...

Navitus Health Solutions is seeking a Pharmacy Relations Specialist II to join our Provider Services team!   The Pharmacy Relations Specialist (PRS II) is a highly motivated professional with at least 2 years of successful experience working in a pharmacy or interfacing directly with pharmacies or accounts, preferably in healthcare.  Responsibilities include executing contracts with pharmacies, responding to pharmacy inquiries, and completing the tactical and operational tasks required to maintain contracted pharmacy networks.   Is this you? Find out more below!

Due to growth we are adding a Specialty Implementation Project Manger to our team!   The Project Manager, Specialty Implementation (SIPM) is a highly motivated professional with at least 3 years of successful client implementation experience. The SIPM is responsible for leading the effort to implement new patients. This position oversees all aspects of the project planning, monitoring, and controlling processes. The SIPM is responsible for the coordination and completion of the implementation and to this end will perform a variety of tasks including setting deadlines, assigning responsibilities, monitoring, and summarizing project...

Due to growth we are adding a Quality Analyst to our team!   The Quality Analyst will be responsible for developing, implementing, and monitoring processes to obtain and audit key performance indicators. Through these processes and programs, the Quality Analyst will continually monitor the abilities, competencies, and service quality delivered by members of the teams and provide reports to area leaders of business and employee key performance indicators.   The Quality Analyst will monitor and audit inbound service calls to assess employee demeanor, technical accuracy, performance, and conformity to company policies and procedures.  The Quality...

Navitus Health Solutions is seeking a Sr. Proposal Analyst to join our team!   The Sr. Analyst, Proposal role is critical to the client acquisition and retention efforts of Navitus Health Solutions. This position works cross-functionally at a variety of levels to maximize sales and retention through the timely creation and management of competitive responses to Requests for Proposals (RFPs) and other sales related documents for a variety of audiences. The Sr. Analyst, Proposal ensures agreed upon strategies are incorporated into persuasive, compelling, and customer-focused proposals. This position ensures the timely completion of projects in accordance with defined project management processes and quality standards.   Is this you? Find out more...

Due to growth, we are adding a Referral Coordinator to our Sales & Sales Support department.     The Referral Coordinator will assist in processing all inbound...

Due to growth, we are adding an Engineer, Development Operations to our IT Infrastructure Services department.    

Due to growth we are adding a Technical Account Executive to our team!   The Technical Account Executive is a customer-facing role who ensures efforts are aligned between the Account Management team, the Navitus Technology teams, key internal business partners, and the customers to support client-focused objectives and the IT Vision. This role is a collaborative partner delivering innovative ideas, solutions, and services to simplify people’s lives. This individual will plan, coordinate, and align resources to support the daily activities of the team. They will create and update business processes to efficiently support client needs. The Technical Account Executive represents both the Customer and...

Due to growth we are adding a Sr. Software Engineer, Data Governance to our team!   The Sr. Software Engineer, Data Governance will help with the implementation and ongoing development of our Collibra Data Intelligence Cloud (DIC) and Collibra Data Quality & Observability platforms. This role will be responsible for the implementation of the Enterprise Data Governance Strategy of data cataloging/metadata management and data quality development within the Collibra DIC and Data Quality & Observability platforms, which will ensure trusted, high-quality data is available across Navitus.   Is this you? Find out more below!

Navitus Health Solutions is seeking a Coordination of Benefits Product Manager to join our team!   The Product Manager, Coordination of Benefits is responsible for the development, administration, maintenance, and oversight of the COB Program. The Product Manager will ensure that the appropriate software, processes, procedures, and oversight monitoring are implemented and operational to meet changing COB program needs. The Product Manager, Coordination of Benefits will work closely with members of the following departments: Analytics, Benefit Systems, Claims Adjudication Development, Client Services, Compliance, Data Services, Government Programs, Implementation, and Member Service, ensuring COB is administered and maintained according to industry, state, federal,...

Navitus Health Solutions is seeking a Sr. Manager, Clinical Account Executive to join our team!   The Sr. Manager, Clinical Account Executive is a highly motivated professional with at least 5 years of successful clinical experience interfacing directly with large complex clients. This key position is responsible for leading and developing Clinical Staff within the Account Management department as well as the co-development of long-term account strategy for the Clients assigned to the team they support. The SMCAE has exceptional clinical, business and relationship building skills and possesses the ability to apply sound clinical judgment to a...

Due to growth we are adding a Provider Services Supervisor to our team!   The Supervisor, Provider Services is a highly motivated professional experience working in a pharmacy or interfacing directly with pharmacies or accounts, preferably in healthcare.  Responsibilities include the oversight for executing contracts and/or credentials with pharmacies, responding to pharmacy inquiries, and completing the tactical and operational tasks required to maintain contracted pharmacy networks. The individual(s) in this position will oversee end to end operational aspects of administration, analysis, and quality assurance for network design and...

Due to growth we are adding a Provider Services Manager to our team!   The Manager, Provider Services is responsible for the oversight for executing contracts, credentials or payment setups with pharmacies, responding to pharmacy inquiries and completing the tactical and operational tasks required to maintain contracted pharmacy networks. The individual will ensure information contained in Navitus’ contract management systems are accurate and up to date. The individual(s) in this position will oversee end to end operational aspects of administration, analysis, and quality assurance for credentials and network design and management through...

Due to growth we are adding a Workforce Mangement Specialist to our team!   The Specialist, Workforce Management. is responsible for supporting workforce management setup, scheduling, analysis, forecasting, etc. to ensure internal and external service levels commitments are achieved. The WFM Specialist performs basic troubleshooting with the workforce management systems including input and output systems and escalates as necessary. This individual will review available data or requests new reports to make recommendations on staffing to consistently meet service levels and run and requests enhancements to analytic reports on a regular and ad-hoc basis that assist in identifying areas of performance...

Navitus Health Solutions is seeking a Manual Claims Coordinator to join our team!   The Coordinator, Manual Claims ensures efforts are in alignment with the Claim Adjudication Operations (CAO) team to leverage technology and process improvement for the purpose of meeting the business needs of Navitus customers, clients, members, and pharmacies by accurately administering benefits. This position is responsible for processing of pharmacy and/or direct member reimbursement (DMR) claims of all levels of complexity to execute the claims adjudication process including correction of claims.   The Coordinator, Manual Claims will manage the day-to-day processes and changes made to a...