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Lumicera Health Services is seeking a Prior Authorization Specialist I to join our team!
Under direction from the Supervisor, Specialty Pharmacy Services, and pharmacists in the Specialty Pharmacy, the Prior Authorization Specialist I is primarily responsible for obtaining information and assisting providers and insurance companies in triaging prior authorizations for patients of the specialty pharmacy. The Prior Authorization Specialist’s main objective is to answer phone calls and contact the doctors and patients via fax or phone or other communication means to facilitate and document prior authorization approval. The Prior...
Navitus Health Solutions is seeking a Sr. Client Services Executive II to join our team!
The Sr. Client Services Executive II (SCSE) is a highly motivated professional with at least 7 years of successful experience interfacing directly with larger more complex clients preferably in healthcare, to manage existing PBM clients. The position is responsible for the co-development of long-term account strategy for their assigned Clients. Working with subject matter experts, the Sr. CSE will be responsible for identifying “up sell” and expansion opportunities and communicating these opportunities appropriately to be incorporated into the annual strategic...
Navitus Health Solutions is seeking an Sr. Account Manager - Health Plans with experience with Government Programs to join our team!
The Sr. Account Manager will be part of an account team that values our client relationships and operational excellence and will play an integral role as the face of our organization to clients daily. The Sr. Account Manager will be responsible for leading projects and operational ownership for some of our most complex and strategic client accounts. The Sr. Account Manager will be responsible for the operational execution of client strategies and plan design and serve as...
Due to Growth, we are adding a Manager, 340B Pharmacy Services to our team!
The Manager, 340B Pharmacy Services is responsible for optimizing successful and compliant participation in the federal 340B program for external partners of Lumicera Health System Solutions and Navitus Clients. This role and the team will work cross-functionally with teams at Lumicera and Lumicera-operated pharmacies to deliver value for partners through designing, implementing, and continually improving workflows and processes in scope of the 340B program. In addition, this role will provide subject matter expertise and guidance for Navitus and...
Navitus Health Solutions is seeking a Sr. Analyst, Financial to join our team!
The Sr. Analyst, Financial performs various financial analysis, forecasting and strategic planning activities. The Financial Analyst compiles financial data in various formats to be used by Senior Leadership, SSM Health, and other key stakeholders in the organization.
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Due to growth, Navitus Health Solutions is seeking a Director of Underwriting and Actuarial to join our team!
The Director, Underwriting and Actuarial is responsible for guiding the actuarial and financial analytics, assumptions, and modeling to support the strategic objectives of Navitus. This leader directs the development, implementation, and monitoring of pricing models and strategies, financial forecasts, trend analytics, and risk modeling for all lines of business, including Medicare, Medicaid, Commercial, Self-Funded, EGWP, and Exchange products.
The Director, Underwriting and Actuarial works collaboratively with executive leadership, underwriting, clinical, and...
Navitus Health Solutions is seeking a Supervisor, Account Management to join our team!
Due to growth, we are adding a Sr. Systems Engineer to join our team!
The ideal candidate for this role will be primary in the support and maintenance of the organization Oracle OCI framework as well as the overall AWS and Azure Cloud platform, applications and secrets management. The Sr. Systems Engineer ensures efforts are in alignment with the IT Enterprise Services Department to support customer-focused objectives and the IT Vision, a collaborative partner delivering innovative ideas, solutions, and services to simplify people's lives.
Due to growth, we are adding a Sr. Manager, EPMO Portfolio Operations to our team!
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...
Due to growth, we are adding a Lead, Change Management to our team!
The Data Engineer is responsible for designing, building, and maintaining scalable data pipelines and infrastructure that support enterprise analytics, reporting, and operational data flows. This role plays a critical part in enabling data-driven decision-making across Centene and SPM by ensuring the availability, integrity, and performance of data systems. The Data Engineer collaborates with data scientists, analysts, software developers, and business stakeholders to deliver robust ETL solutions, optimize data storage and retrieval, and implement secure, compliant data architectures in cloud and hybrid environments.
Operating within a healthcare-focused, compliance-heavy landscape, the Data Engineer ensures that data platforms...
The Data Engineer is responsible for designing, building, and maintaining scalable data pipelines and infrastructure that support enterprise analytics, reporting, and operational data flows. This role plays a critical part in enabling data-driven decision-making across Centene and SPM by ensuring the availability, integrity, and performance of data systems. The Data Engineer collaborates with data scientists, analysts, software developers, and business stakeholders to deliver robust ETL solutions, optimize data storage and retrieval, and implement secure, compliant data architectures in cloud and hybrid environments.
Operating within a healthcare-focused, compliance-heavy landscape, the Data Engineer ensures that data platforms...
Due to growth, we are adding a Solutions Architect to our team!
Due to growth, we are adding a Sr. Product Manager to our team!
Navitus Health Solutions is seeking a Pricing and Underwriting Analyst II to join our Lumicera Specialty Pharmacy team!
The Analyst II, Pricing and Underwriting is responsible for supporting the Pricing and Underwriting team with financial price modeling of provider networks, manufacturer rebates, cost of risk, and client administrative fees. The Analyst II will support the growth team with client proposals and will be responsible for performing an array of analyses and...
Navitus Health Solutions is seeking a Business Intelligence Developer to join our team!
The Business Intelligence Developer will generate and maintain data and analytic solutions that turn data into knowledge. The Business Intelligence Developer should understand how to interpret databases, develop data models within business intelligence (BI) tools and provide maintenance on existing applications.
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Navitus Health Solutions is seeking a Platform Engineering and FinOps Manager to join our team!
The Manager, Platform Engineering and FinOps leads a team focused on enabling secure, scalable, and cost-effective software delivery platforms. This role oversees platform engineering functions such as CI/CD pipelines, developer tooling, and container orchestration, observability, while also managing the cloud financial operations (FinOps) and software procurement functions. This role partners closely with the Infrastructure and Cloud Operations team to ensure alignment on tooling, architecture, platform reliability and cost governance.
The Manager,...
Are you interested in working Monday to Friday (NO WEEKENDS) in a clean, bright environment with heat, air conditioning and best-in-class health benefits?
Lumicera Health Services is seeking a Pharmacy Technician at our Madison Facility! This role works at our state-of-the-art warehouse and is not in person patient-facing.
Archimedes is a rapidly growing leader in the specialty drug benefit management space. We are looking for a Case and Utilization Manager to coordinate care between physicians, patients and pharmacies. This is a great opportunity for a dependable and dedicated candidate with a passion for helping patients taking specialty medications to treat complex disease states.
The Product Account Manager will support a key account and product. In addition to supporting the client relationship, this role will lead product management and project manage operational projects for this product. The role will be responsible for managing any client requests for builds and any necessary drug lists and formularies.
The Product Account Manager will interact with the account, product, and clinical management teams. This role will be responsible for managing and implementing any client specific product specific requirements, such as a custom formulary
The Product Account Lead will support a key account and product. In addition to supporting the client relationship, this role will lead product management and project manage operational projects for this product. The role will be responsible for managing any client requests for builds and any necessary drug lists and formularies.
The Product Account Lead will interact with the account, product, and clinical management teams. This role will be responsible for managing and implementing any client specific product specific requirements, such as a custom formulary
Lumicera Health Services is seeking a Reimbursement Specialist I to join our team!
Under direction from the Assoc. Manager, Specialty Pharmacy Services, Reimbursement Team Lead, and pharmacists in the Specialty Pharmacy, the Reimbursement Specialist I is primarily responsible for following standard operating procedures to obtain and process manufacturer copay assistance program reimbursement. The Reimbursement Specialist I shall have knowledge of billing procedures and work to reduce discrepancies, inaccuracy, and outstanding balances. The Reimbursement Specialist I may also assist in contacting patients with an outstanding balance to...
Due to growth we are adding an Intake Specialist to our team!
Under direction from the Assoc. Manager, Patient Support Services and pharmacists in the Specialty Pharmacy, the Intake Specialist I is primarily responsible for enrolling new Specialty Pharmacy patients and ensuring that all pertinent patient information is contained within the record. Patient information shall include demographics, allergies, medication history, comorbidities, and payer information. The Intake Specialist I’s main objective is to place phone calls to new and existing patients, answer phone calls and contact the doctors and patients via fax or phone or other communication means. The Intake Specialist I is also responsible...
Are you interested in working Monday to Friday (NO WEEKENDS) in a clean, bright environment with heat, air conditioning and best-in-class health benefits?
Due to growth, we are adding a Fulfillment Specialist to our Specialty Pharmacy Operations-Madison department.
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 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: first review of prior authorization of specialty medications against clinical policies, high cost case management support functions and internal clinical process development and maintenance activities. In addition, this...
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...
Due to growth, we are adding a Patient Care Assistant to our team!
Under general direction of the Supervisor, Pharmacy Services the person employed in this Patient Care Assistant/ Customer Service position will assist with the Specialty Pharmacy programs. Primary responsibility is to effectively communicate with patients, physicians, pharmacists, and payers to assist in the fulfillment and patient care of specialty pharmacy...
Due to growth, we are adding an Enterprise Solutions Architect to our IT Enterprise Architecture department.
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...
Due to growth we are adding a Sr. Coordinator, Clinical Client Services to our team!
The Sr. Coordinator, Clinical Client Services (SrCCSC) is a highly motivated professional with at least 4 years of successful experience interfacing directly with clients and clinical team to assist Clinical Account Executives (CAE) in completing the tactical and operational tasks required to meet the needs of our PBM clients. The position is responsible for participating in issue resolution and daily support of client requests, responding to general internal and external inquiries regarding claims processing, and assisting new client implementations. In...