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...

Reporting to Senior Manager, Client Rebate Operations, the Analyst is responsible for operational aspects of Navitus’ rebate programs including, but not limited to rebate optimization, rebate guarantee reconciliation and reporting, sales and request for proposal (RFP) support, and client operations.   Is this you? Find out more below!

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 Talent Acquisition Coordinator to join our Talent Acquisition team!   The Coordinator, Talent Acquisition (CTA) will provide front line support for the recruiting function.  Reporting to the Sr. Manager, Talent Acquisition, the CTA will assist the HR department in carrying out programs, processes, policies, and procedures; including duties related to recruitment, hiring, record keeping, new hire file maintenance, and compliance with state and federal employment laws. The CTA will ensure accurate new employee records in accordance with employment regulations; assist in the full-service recruiting process which may include interview...

Navitus Health Solutions is seeking a Client Services Executive to join our 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...

Archimedes is a rapidly growing leader in the specialty drug benefit management space. We are looking for a Supervisor, Member Services in our Earth City, MO Office. 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.

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...

The Operations Director is a highly motivated professional with 5+ years of experience successfully managing complex operations. This individual is responsible for strategic and tactical execution and management of claims, contact center and various other operations.

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!

We are seeking a dedicated Quality Control Team Leader to join our dynamic team. The selected candidate will support our Call Center operations with emphasis on developing and enforcing quality control standards and criteria for evaluating customer interactions, including calls, emails, and chats. Lead and drive efforts to continuously improve quality control processes and methodologies based on performance data and feedback. Be the Subject Matter Expert by delivering clear and constructive feedback to agents based on quality control evaluations, focusing on both strengths and areas of improvement. Drive collaboration by coordinating with other inter departmental functions such as operations and training, to align quality control efforts with overall call center...

  This position 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 Benefit Configuration Analyst 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 timely. Individuals in this role must use sound business judgement and demonstrate the ability to continually prioritize tasks, as...

Navitus Health Solutions is seeking a Telehealth Pharmacy Technician to join our CEC Operations department!    This position will have the opportunity to impact patient’s health every day via the delivery of best-in-class interventions and patient care. Working with pharmacists, nurses and a supportive leadership team, the Telehealth Pharmacy Technician (CPhT) is responsible for aiding in the delivery of clinical interventions and Medication Therapy Management (MTM) services for commercial and Medicare...

Due to growth, we are adding a Lead Analyst, IT Governance to our IT Infrastructure Services department.   The Lead Analyst, IT Governance is responsible for developing and maintaining IT policies, procedures, guidelines, and standards in alignment with ITIL best practices. This role will work directly with application developers, business users, internal...

Due to growth we are adding an Account Management Trainer to our team! The Account Management Trainer is a highly motivated professional with at least 2 years of successful experience in training or adult learning. While proficiency and deep knowledge of policies, procedures, tools, and applications are essential, these can be acquired over time. The Trainer is responsible for developing learning content, creating departmental training programs, drafting training schedules, and executing tactical and operational tasks to meet the training needs of Account Management team members.  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 an Analyst, Pricing and Underwriting to join our Finance Administration department! ...

Navitus Health Solutions is seeking a Sr. Proposal Analyst to join our team!   The Sr. Proposal Analyst provides supports and/or leads the client acquisition and/or industry partnership opportunities and retention efforts for assigned business units. This includes creation and management of strategic and client-focused proposal content, written proposals, and other sales-related documents for a variety of client and/or industry partner audiences—current, prospective, and consultant. Successfully creates competitively positioned content and supports sales activities that result in significant market share and profitability and convey a powerful corporate image to the marketplace. Ensures on-time and quality completion of projects, through a collaborative effort...

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,...

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...

We are seeking a dedicated Quality Control Team Leader to join our dynamic team. The selected candidate will support our Call Center operations with emphasis on developing and enforcing quality control standards and criteria for evaluating customer interactions, including calls, emails, and chats. Lead and drive efforts to continuously improve quality control processes and methodologies based on performance data and feedback. Be the Subject Matter Expert by delivering clear and constructive feedback to agents based on quality control evaluations, focusing on both strengths and areas of improvement. Drive collaboration by coordinating with other inter departmental functions such as operations and training, to align quality control efforts with overall call center...

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.  

Due to growth we are adding a Supervisor, Specialty Pharmacy Support Services to our team!   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...

As a key member of the Enterprise Architecture team, you will help shape the strategic vision of our technology ecosystem. Your role is critical in aligning both on-premises and AWS cloud infrastructure with enterprise applications to support long-term business objectives. You will ensure that every system, process, and platform is architected for scalability, resilience, and innovation.   Your ability to design and deliver enterprise-grade solutions will directly impact our customers by enabling seamless, secure, and future-ready technology experiences. Prior experience in solutioning and developing enterprise-scale architectures is highly valued and will contribute to your success in this role.  

Navitus Health Solutions is seeking a Quality Analyst to join our Quality department!   The Quality Analyst (QA) is a member of the Accreditation Quality Team (AQT) and is responsible for supporting and coordinating quality activities performed by Navitus Health Solutions. The QA will work with an advanced level of independence to ensure quality requirements are completed in a timely manner. This individual requires an advanced understanding of quality standards and processes and will provide training and guidance to the Navitus teams impacted. The QA is responsible for Navitus Quality Program maintenance to include policy and procedure...

Due to growth we are adding a Prior Authorization Specialist to 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 Authorization Specialist...

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...

Navitus Health Solutions is seeking a Project Manager, Implementation TPA/Employer to join our Implementation department!   The Project Manager, Implementation TPA/Employer (IPMT) is a highly motivated professional with at least 3 years of successful project management experience interfacing with TPA and/or employer type clients to manage projects that could include but is not limited to transitioning clients to Navitus from their current PBM, implementing new services/programs, and facilitating a change in vendor relations. The position is responsible for building an early relationship with the clients so they learn to trust us and have confidence that their transition needs will be...

Due to growth we are adding a Analyst, Pharmacy Contract Audit to our Pharmacy Network Operations department!   The Analyst, Pharmacy Contract Audit is responsible for the oversight of Navitus’ contractual pharmacy network reimbursement accuracy. The individual in this position is expected to make independent assessments to confirm Navitus is conforming to contractual reimbursement obligations contained in Retail, Specialty, and Mail Order pharmacy agreements. The Analyst will continually review and monitor claims data, create, and update procedures, audit networks for price change accuracy, monitor compliance with Navitus pharmacy...

Due to growth we are adding a Analyst, Pricing and Underwriting to our Finance Administration department!   The Analyst, Pricing and Underwriting

Due to growth we are adding a Business Analyst, Government Programs-Med D to our team!   The Business Analyst provides business analysis support for development, implementation, and maintenance of all products within the Technical Operations Department. The Business Analyst interacts with key operating departments related to Technical Operations business development and operational compliance. The 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 state-specific...

Navitus Health Solutions is seeking a Reimbursement Analyst, Pharmacy Network to join our Provider Services department!   The Analyst supports and evaluates agreements with providers and the Maximum Allowable Cost (MAC) program through financial price modeling, analysis, and reporting. This position will communicate and work cross functionally with other teams on generic trends and generic drug discount change effects. Provider and network performance will be analyzed in support of network development, contracting negotiations, and RFP proposals.  The Analyst, under the direction and supervision of the Provider Services leadership, is responsible for maintaining a competitive and...

Navitus Health Solutions is seeking a Sr. Client Services Executive I to join our Contract Performance Management department!

Due to growth, we are adding a Sr. IT Business Relationship Manager to our IT Management department. 

Due to growth, we are adding a Sr. IT Business Relationship Manager to our IT Management department. 

Due to growth, we are adding a Sr. Paralegal to our Legal & Regulatory Affairs department.

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

Due to growth we are adding a Clinical Account Executive (RPh) to 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 evaluating clinical programs and services. The Clinical Account Executive focuses on a proactive, consultative and comprehensive approach. The position is a key member of the Client Services Team and is responsible for the account relationship and ultimate retention of the account and growth of the business. Proficiency...