The Financial Analyst, Medicare Part D serves as a subject matter expert in Medicare Prescription Payment Plan (M3P) billing & collection financial operations. This position is responsible for overall reconciliation of M3P financial processes for Navitus EGWP clients, including collaboration with Navitus Finance on integration with corporate billing system and general ledger. This role oversees all financial processes delegated to Navitus M3P vendor and 3rd party M3P vendors for our Part D Health Plan clients. M3P client financial reporting is also part of the scope of this position. 

Lumicera Health Services is seeking a Pharmacist, Clinical Operations to join our team!   The Pharmacist, Clinical Operations’ main duty is to interpret physicians' prescriptions, contact doctors or other prescribers and/or patients to verify information on prescriptions and expedite processing of orders. This role will perform a high volume of product verification both prior to order set up as well as immediately prior to shipment. The Pharmacist, Clinical Operations will...

  As a Team Lead, Account Management, you will lead a team of Account Managers and Sr. Account Managers as well as hold a small book of business comprised of key accounts.  The Team Lead will be responsible for the coaching, development and performance of a team as well as serve as a resource for escalated client situations.  Coaching the team on the core competencies of their role will be an essential part of your responsibilities. Forming incoming and rising talent across our Customer Success department is vital to our continued success and growth strategies.    The Team Lead will serve as a member of a client account team that values our client relationships...

Navitus Health Solutions is seeking a Claims Quality Analyst to join our team!   The Claims Quality Analyst is responsible for validating that Med D, Medicaid, and Exchange claims are adjudicating per State/CMS regulations as well as specific client needs.  

Navitus Health Solutions is seeking a Analyst, Technical Operations, Government Programs to join our team!   The 

Navitus Health Solutions is seeking a Scrum Master to join our IT Delivery department!   

Navitus Health Solutions is seeking a Specialist, Prior Authorization to join our Prior Authorization department!    The Specialist I, Prior Authorization (PAS) will review, process, and troubleshoot incoming Prior Authorization requests for various medications. The Specialist I, Prior Authorization (PAS) will accurately...

Navitus Health Solutions is seeking an Associate Manager, Implementation to join our Implementation department! 

Navitus Health Solutions is seeking a Pharmacist, Clinical Outcomes to join our Lumicera Clinical Services department!

Navitus Health Solutions is seeking a Sr. Proposal Analyst to join our Proposals department!   The Sr. Analyst I, Proposal supports and/or leads the client acquisition and retention efforts of Navitus...

Due to growth, we are adding Systems and Quality Analyst Manager to our team.    The Systems and Quality Analyst Manager will provide support for the development, implementation, and maintenance of our FFS Medicaid products.   The FFS...

The Sr. Business Analyst provides business analysis support to the development, implementation, and maintenance of all products within the Fee For Service(FFS) Department. The Sr. Business Analyst will interact with key operating departments related to Fee For Service (FFS) Department business development and operational compliance. The Sr. Business Analyst also understands the roles and responsibilities of the business area and how it fits within the entire corporation. This individual develops an understanding of Government Programs regulations and related CMS and/or specific state guidance and is responsible for proactive review of all...

Due to growth, we are adding a Contract Performance Analyst to our team!   This position is responsible for providing, gathering, monitoring, and reporting on contractual guarantees for Navitus clients.   The Analyst will collaborate with all functional areas to establish and maintain centralized guarantee data and provide corporate and client reporting information.  An important aspect of this role includes the facilitation and coordination of communication with internal staff and external...

Due to growth, we are adding Pharmacy Relations Specialist to our Pharmacy Network Operations department.     The Pharmacy Relations Specialist (PRS) is a highly motivated professional with at least 3 years of successful experience working in a pharmacy or interfacing directly with pharmacies or accounts, preferably in healthcare....

Due to growth, we are adding a Pharmacy Reimbursement Administrator to our Provider Services department.     The Pharmacy Reimbursement Administrator (PRA) 

The incumbent will be responsible for providing first level technical assistance and support related to computer systems, hardware, or software. Respond to queries, execute basic diagnostic programs, isolate problem, and determine proper escalation.   Individuals in this job position are competent to perform work at the entry level technical skill set within this job family. They have some familiarity with information technology systems and processes.   Is this you? Find out more below!

Navitus Health Solutions is seeking a Clinical Account Executive to join our Clinical Account Management department!   This key position acts as manager and coordinator of the clinical relationship with existing clients. The objective of the clinical relationship with the client is to improve the quality of care while controlling or decreasing overall health care costs.  This is accomplished by recommending, implementing and evaluating clinical programs and services. The...

EpiphanyRx is seeking a Clinical Account Executive to join our team!   This key position acts as manager and coordinator of the clinical relationship with existing clients. The objective of the clinical relationship with the client is to improve the quality of care while controlling or decreasing overall health care costs.  This is accomplished by recommending, implementing and...

Due to growth, we are adding Pharmacy Technician to our Clinical Care 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...

Using deep PBM knowledge and experience with pharmacy reimbursement methodologies and generic drug pricing, plus previous team management experience, this role will support and advise senior leadership regarding provider agreements, administration of the MAC Program, and network adequacy.    Putting People First in Pharmacy- Navitus was founded as an alternative to traditional pharmacy benefit manager (PBM) models.  We are committed to removing cost from the drug supply chain to make medications more affordable for the people who need them.   At Navitus, our team members work in an environment that celebrates diversity, fosters creativity and encourages...

Due to growth, we are adding this Contracting and Audit Specialist to our Trade Relations department.   The Contracting and Audit Specialist will assist with the business needs of the payer relations and contracting team which may include supporting proactive contracting compliance to prepare for and/or mitigate future audits, and respond to requested audits, prescription validations, and audit responses such appeals and requests for additional information. The primary responsibility of this position is to effectively manage all payer program compliance and responding...

Due to growth, we are adding a Analyst, Vendor Risk Management to our compliance department.   The Analyst, Vendor Risk Management responsibilities will be to help in the in the onboarding and ongoing maintenance of Navitus’ vendor relationships.  Under the oversight of the Sr Vendor Risk Manager, you will partner with various internal business owners to properly risk assess vendor relationships, set guidance on document collection, and connect with various Subject Matter Experts in...

The IT Support Technician will be responsible for providing first level technical assistance and support related to computer systems and hardware.  Respond to queries, execute basic diagnostic programs, isolate problems, and determine proper escalation within Navitus and/or vendor support.  Individuals in this job position are competent to perform work at the entry level technical skill-set within this job family.  They have some familiarity with information technology systems and processes.   Is this you? Find out more below!

Putting People First in Pharmacy- Navitus was founded as an alternative to traditional pharmacy benefit manager (PBM) models.  We are committed to removing cost from the drug supply chain to make medications more affordable for the people who need them.   At Navitus, our team members work in an environment that celebrates diversity, fosters creativity and encourages growth.  We welcome new ideas and share a passion for excellent service to our customers and each other.   Due to growth, we are adding this Clinical Product Manager to our Clinical Engagement Center department.   We are unable to offer remote work to residents of Alaska,...

Navitus Health Solutions is seeking a Coordinator, Client Services to join our Account Management team!   The Client Services Coordinator (CSC) is a highly motivated professional with experience interfacing directly with clients preferably in healthcare. Responsibilities include completing the tactical and operational tasks required to meet the needs of our existing PBM clients.    The position is responsible for collaborating with the Client Service Representatives to execute all PBM functions on behalf of the clients. This includes all assigned responsibilities in working with the Client Service...

Due to growth, we are adding Specialty Trade Market Executive to our Lumicera Trade Relations team.   The Specialty Trade Account Executive provides supports and/or leads the client acquisition and/or industry partnership opportunities and retention efforts for assigned business units. This includes the management of strategic industry relationships, implementations of service, and other sales-related initiatives for a variety of client and/or industry partner audiences—current, prospective, and consultant.    Successfully satisfy the needs of our industry partners...

Lumicera Health Services is seeking a Pharmacist in Charge to join our Clinical Services team!   The Pharmacist in Charge (PIC) is an active pharmacist responsible for the management of day-to-day pharmacy operations and ensuring compliance with all regulations governing the operation of the assigned specialty pharmacy location including licensing of the pharmacy. The PIC provides direct or indirect supervision to all specialty pharmacy staff responsible for duties within the dispensing pharmacy, including clinical pharmacists, interns, pharmacy technicians, fulfillment specialists, and any other support staff. The PIC develops pharmacy team members, helps maintain...

Due to growth, we are adding a Client Services Specialty Coordinator to our Strategic Partnerships team.   The Client Services Coordinator (CSC) is a highly motivated professional with at least 5 years of successful experience interfacing directly with varied complex customers preferably in healthcare, to manage existing clients and strategic partners. The position is responsible for the co-development of long-term account strategy and supporting the National Specialty Account Executive for their assigned client.   Working with other operational staff to provide the client and their patients an exceptional service and high...

Due to growth, we are adding Sr. Analyst, Revenue Cycle Management to our Accounting team.   The Sr. Analyst, Revenue Cycle Management is responsible for supporting the Sr. Manager, Revenue Cycle Management in implementation and ongoing administration of best-in-class billing and accounts receivable systems and processes.  The primary goal of this role is to reduce manual efforts for billing and collections both internally and for clients, with a focus on delivering exceptional client experiences with this component of their relationship with Navitus.   The incumbent in this role will also provide guidance and support to...

Due to growth, we are adding a Analyst, Revenue Cycle Management to our Accounting team.   The Analyst, Revenue Cycle Management is responsible for supporting the Sr. Manager, Revenue Cycle Management in implementation and ongoing administration of best-in-class billing and accounts receivable systems and processes.  The primary goal of this role is to reduce manual efforts for billing and collections both internally and for clients, with a focus on delivering exceptional client experiences with this component of their relationship with Navitus.   The incumbent in this role will apply broad knowledge of billing, accounts...

Due to growth, we are adding Sr. Manager, Revenue Cycle Management to our Accounting team.   The Head of Revenue Cycle Management is responsible for setting the strategic and operational direction for billing and collection of accounts receivable.  The incumbent in this role is also responsible for collaborating with Navitus' industry relations and rebate teams in the processing of drug rebates from collection to allocation and distribution to clients.   The leader in this role must be focused on driving efficiencies, billing and accounts receivable balance and aging accuracy, exceptional customer interactions, a great place to...

Navitus Health Solutions is seeking a Client Services Executive to join our Account Management team!   The Client Services Executive (CSE) is a highly motivated professional with at least 5 years of successful experience interfacing directly with varied complex clients preferably in healthcare, to manage existing Pharmacy Benefit Management clients. The position is responsible for the co-development of long-term account strategy for their assigned clients. Working with subject matter experts, the CSE will be for responsible for identifying “up sell” and expansion opportunities and communicating these opportunities appropriately to be incorporated into the...

Putting People First in Pharmacy- Navitus was founded as an alternative to traditional pharmacy benefit manager (PBM) models.  We are committed to removing cost from the drug supply chain to make medications more affordable for the people who need them.   At Navitus, our team members work in an environment that celebrates diversity, fosters creativity and encourages growth.  We welcome new ideas and share a passion for excellent service to our customers and each other.   We are unable to offer remote work to residents of Alaska, Hawaii, Maine, Mississippi, New Hampshire, New Mexico, North Dakota, Rhode Island, South Carolina, South Dakota, West Virginia, and Wyoming. The...

Due to growth, we are adding an Accreditation Coordinator to our Lumicera Quality department! Lumicera is looking for an Accreditation Coordinator that will support our pharmacy accreditation program(s) requirements. This role will...

What can you expect from Navitus? - Hours/Location: Monday-Friday between 8:00am-8:00pm CST, hybrid Madison WI  - Paid Volunteer Hours - Educational Assistance Plan and Professional Membership assistance - Referral Bonus Program – up to $750! - Top of the industry benefits for Health, Dental, and Vision insurance, Flexible Spending Account, Paid Time Off, Eight paid holidays, 401K, Short-term and Long-term disability, College Savings Plan, Paid Parental Leave, Adoption Assistance Program, and Employee Assistance Program Putting People First in Pharmacy- Navitus was founded as an alternative to...

Navitus Health Solutions is seeking a Medication Access Specialist to join our Specialty Programs department!  

Navitus Health Solutions is seeking a National Account Executive to join our Strategic Account Management team! 

Navitus Health Solutions is seeking a Sr. Software Developer to join our IT Development department! 

The Project Manager, Implementation HP Strat. Clients (IPM) is a highly motivated professional with at least 4-6 years of successful project management experience. This IPM will interface with health plans and strategic employer clients which may include a government program component to manage projects including transitioning clients to Navitus from their current PBM, implementing new services/programs, facilitating a change in vendor relations, i.e. TPA, disease management organization, etc. and more. The position is responsible for the building an early relationship with the clients so they learn to trust us and have confidence that their transition needs will be successfully met as seamlessly as possible. The IPM must have strong relationship skills to be able to work with not only...