Due to growth, we are adding a Sr. Coordinator, Medicaid and Exchange to our Government Programs department. 

Due to growth, we are adding Vendor Relationship Coordinator to our team!   The Vendor Relationship Coordinator’s primary role is to support the day-to-day operations of the BPO Vendor Manager on behalf of Lumicera, ensuring quality delivery of a variety of administrative and office related tasks. The Vendor Relationship Coordinator plays a vital role in the success of BPO daily operations, working closely with the Vendor Manager and Operations Leadership staff to provide general support in helping the Call Center and Prior Authorization achieve their desired results.   Is this you? Find out more below!

Navitus Health Solutions is seeking a Supervisor, Claim Adjudication to join our team!    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.   Is this you? Find out more below!...

Lumicera Health Services is seeking a Pharmacy Technician to join our Irvine location!    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 medication into the pharmacy dispensing software.   The Pharmacy Technician I may also...

Navitus Health Solutions is seeking a Implementation Operations Analyst to join our Implementation department!    The Implementation Operations Analyst is a highly motivated professional with at least 3 years successful implementation experience and solid knowledge of Microsoft Excel, Word, PowerPoint, Visio and SharePoint. Experience with CRM, Smartsheet, NCRx, 3D and various reporting tools are a plus. Ability to analyze and interpret data is required. Business writing experience is a plus. Ability to plan, organize and focus on details is critical. The Implementation Operations Analyst must have strong relationship skills to be able to...

Navitus Health Solutions is seeking a Sr. Product Manager, Medicaid to join our Government Programs department!    The Sr. Product Manager, Medicaid (SPM) will lead efforts to design, develop, and implement various Medicaid software and associated process changes according to requirements defined by the Centers for Medicare and Medicaid Services (CMS) and each State regulating entity. The PM is responsible for reviewing and acting upon all CMS and State guidance related to these functions, including technical guidance as well as business process-related guidance. The PM ensures that the appropriate software, processes, and procedures are...

Lumicera Health Services is seeking a Industry Relations Manager to join our team!   Reporting to the Director, Strategic Partnerships, the Manager, Industry Relations is responsible for establishing, maintaining, and enhancing effective relationships with pharmaceutical manufacturers (manufacturer) that produce specialty pharmaceuticals; and negotiating contracts with such manufacturers to ensure the specialty pharmacy can obtain specialty pharmaceuticals and pricing to meet the demands of its payers and patients. Additionally, the Manager, Industry Relations is responsible for clinical drug pipeline and maximizing access to products that the specialty pharmacy has a strategic interest in dispensing. This...

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 into the annual strategic...

Navitus Health Solutions is seeking a Sr. Manager, Population Health to join our Population Health department!   The Senior Manager, Population Health provides strategic vision and operational oversight of the department as well as direct management and leadership of clinical staff within the department. The Senior Manager ensures timely program execution, represents products to external and internal clients, and drives results in support of the corporate strategic plan. The Senior Manager will have responsibility for the required clinical services and for driving outcome analysis initiatives to completion. The Senior Manager is responsible for duties related to the development, implementation, outcomes reporting, and...

Lumicera Health Services is seeking a Product Owner, IT to join our Lumicera IT 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...

Lumicera Health Solutions is seeking a Supervisor, Medication Inventory and Procurement to join our Trade Relations department!   The Supervisor, Medication Inventory and Procurement leads the management and procurement of pharmacy inventory from primary and secondary wholesale partners. This includes the management of strategic industry relationships, implementations of service, and negotiating with a variety of supply chain clients and/or industry partner audiences—current, prospective, and consultant.   Is this you? Find out more below!

Due to growth, we are adding Sales Support Coordinator to our Sales and Marketing department.     The Coordinator, Sales Support supports the client acquisition and retention efforts of Navitus Health Solutions by providing professional and timely support to the Navitus Sales team and other customers. The Coordinator, Sales Support supports day-to-day CRM activities and plays a key role in...

Due to growth, we are adding a Lead, Medicaid Audits to our Government Programs department.    This position will have responsibility to establish centralized administration processes for external Medicaid regulatory audits. The Lead, Medicaid Audits (LCA) directs the audit...

Due to growth, we are adding Product Liaison to our team!    The Product Liaison will be responsible for managing and supporting both existing and new product programs for assigned key account clients. The Product Liaison will manage and coordinate the implementation and execution of our access guidance services, QALYiQ, specialty access program, MAP Formulary/Medical Carve Out and other programs as assigned, collaborating with internal partners at both Navitus and EpiphanyRx (ERx). The Product Liaison will act as a bridge...

Navitus Health Solutions is seeking a Pharmacist I, Clinical Prior Authorization to join our Prior Authorization department!    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...

Due to growth, we are adding a Sr. Analyst, Data Governance to our Data department.     The Sr. Analyst, Data Governance role has a direct impact on maturing the...

Navitus Health Solutions is seeking a Client Advocate to join our team!    The Client Advocate (CA) acts as a hybrid of Account Representative and Case Manager to advocate on behalf of the client’s pharmacy benefit program. The CA will field inbound escalation requests from client representatives such as benefit professionals or health care facilitators to assist with escalated member research cases. The CA will collect relevant information and work across the Navitus organization to identify, understand, and determine next steps for resolution. The CA may make outbound communications to members, prescribers and/or pharmacies to...

Navitus Health Solutions is seeking a Network Contracting Manager to join our Pharmacy Network Contracting department!    The Network Contracting Manager will be responsible for the management of retail, specialty, and mail order pharmacy contracting, issue management, reporting, and network strategy in support of Navitus’ objectives. The primary responsibility is to develop, implement, execute, and provide ongoing management of pharmacy...

Navitus Health Solutions is seeking a Coordinator, Eligibility to join our CAO Client department!    The Coordinator, Eligibility 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 Coordinator, Eligibility is responsible for the...

Navitus Health Solutions is seeking a Accumulator Coordinator to join our CAO Client department!   The Accumulator Coordinator 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 role is responsible for the ongoing management of client accumulator processes and will function as the lead accumulator resource for assigned clients, as well as a back-up resource for peer...

Due to growth, we are adding a Pharmacist in Charge to our Specialty Pharmacy Operations department.    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...

Navitus Health Solutions is seeking a Account Manager to join our Business Development department!   The 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 Account Manager will be responsible for the operational execution of client strategies and plan design and serve as the voice of the customer cross-functionally throughout the organization. Through operational expertise, The Account Manager will be able to advise clients and co-workers on plan design considerations and opportunities for...

Navitus Health Solutions is seeking a Sr. Coordinator, Contract Performance to join our Contract Performance Management department!    The Sr. Coordinator, Contract Performance is responsible for maintaining centralized data and reporting of contractual guarantees for current and prospective Navitus clients. The Sr. Coordinator will collaborate with all functional areas to gather 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 customers. The Sr....

Due to growth, we are adding a Release Train Engineer to our IT Delivery department.    The Release Train Engineer (RTE) provides servant leadership and coaching to a program level Agile Release Train (ART) containing multiple cross-functional agile teams through the effective...

Due to growth, we are adding a Analyst, Pharmacy Network Pricing to our Finance & Administration department.    The Analyst, Pharmacy Network Pricing is responsible for financial price modeling of reimbursement systems and evaluation of provider networks. This includes...

This is a hybrid position in Madison WI.    Due to growth, we are adding a Paralegal to our Legal & Regulatory Affairs. 

Navitus Health Solutions is seeking a Product Manager, Innovative Pharmacy Programs to join our Innovative Pharmacy Programs department!    The Product Manager (PM) will be responsible for managing operations for both existing products and new product development for assigned specialty and strategic products. Working under the direction of the Assoc. Director, Innovative Pharmacy Programs, the PM will manage and coordinate the execution for certain Innovative Pharmacy Programs. The PM will oversee day-to-day...

Navitus Health Solutions is seeking a Account Manager to join our Business Development department!   The 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 Account Manager will be responsible for the operational execution of client strategies and plan design and serve as the voice of the customer cross-functionally...

Due to growth, we are adding a Sr. Analyst, Implementation Process to our Implementation department.   Sr. Analyst, Implementation Process is responsible for collaborating with the Implementation Team and their business partners to document and define client implementation practices,...

Due to growth, we are adding a Health System Business Development Executive to our Lumicera Sales & Account Mgmt department.    The Health System Business Development Executive at Lumicera Health Services will play a pivotal role in expanding our reach within the healthcare sector, focusing on establishing and nurturing partnerships with hospitals and health systems. Reporting to the Director, New Business Operations, this position demands a seasoned professional with a robust background in healthcare sales, capable of engaging...

Navitus Health Solutions is seeking a Business Analyst, Government Programs, Med-D to join our Government Programs Technical Operations department!   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...

This position is remote but candidates must reside in North Carolina.    Navitus Health Solutions is seeking a Clinical Account Executive to join our Account Management Clinical 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,...

Due to growth, we are adding Client Onboarding Advisor - Specialty Pharmacy Network Management to our Pharmacy Network Operations department!   The Client Onboarding Advisor will play a key role during new client implementations to understand the client’s current processes, requirements and goals and will cross reference these to Navitus’ product offerings to strategize on how to meet the client’s needs. This individual is responsible for the creation and execution of onboarding plans created specifically for the client and will oversee the entire onboarding process end-to-end for their functional area. The Client Onboarding Advisor will act as a key member of the...

Due to growth, we are adding Client Onboarding Advisor - Pharmacy Operations to our Pharmacy Network Operations department.   The Client Onboarding Advisor will play a key role during new client implementations to understand the client’s current processes, requirements and goals and will cross reference these to Navitus’ product offerings to strategize on how to meet the client’s needs. This individual is responsible for the creation and execution of onboarding plans created specifically for the client and will oversee the entire onboarding process end-to-end for their functional area. The Client Onboarding...

Navitus Health Solutions is seeking a Business Intelligence Developer to join our Analytics department!   The Business Intelligence Developer brings together theory and practice to identify and communicate data-driven insights that allow managers, stakeholders, and other executives in the organization to make informed decisions. The Business Intelligence Developer will have an intermediate understanding of the company’s databases, business intelligence (BI) tools, and existing reports and act as a resource in internal and external meetings. A good candidate will be detail oriented, analytical, a skilled communicator, and a quick learner with experience in analytics, data modeling,...

Due to growth, we are adding Client Onboarding Advisor - Pharmacy Network Management to our Pharmacy Network Operations department!   The Client Onboarding Advisor will play a key role during new client implementations to understand the client’s current processes, requirements and goals and will cross reference these to Navitus’ product offerings to strategize on how to meet the client’s needs. This individual is responsible for the creation and execution of onboarding plans created specifically for the client and will oversee the entire onboarding process end-to-end for their functional area. The Client Onboarding...

Due to growth, we are adding a technical data modeling and forecasting Sr. Manager, Pharmacy Network Informatics to our team!  This is a great role for a leader with sound data modeling experience. (Not a sales role.)   The Sr. Manager, Pharmacy Network Informatics will oversee and manage the Pharmacy Network Informatics Team. This position will support the Navitus Provider Services, Sales, Account...

Due to growth, we are adding a Staff Attorney to our Legal & Regulatory Affairs department.    The Staff Attorney will assist the Navitus Chief Legal Officer and Associate General Counsel with legal matters and be responsible for drafting legal documents and templates, performing legal...

Navitus Health Solutions is seeking a Benefit Configuration Tester to join our team!    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 primary functions of the Tester, Benefit Configuration involve performing and documenting benefit configuration testing ensuring Navitus maintains an accurate, efficient, and versatile claims adjudication system. This position develops tactical tasks and processes to incorporate client and company initiatives into testing to ensure...

Due to growth, we are adding Technical Operations Supervisor to our Government Programs Technical Operations department!     The Supervisor Technical Operations is responsible for leading Technical Operations team members. This individual will interact with key operating departments related to Technical Operations business development and operational compliance and...

Navitus Health Solutions is seeking an Analyst, PA Accel  to join our Prior Authorization department!    The Analyst, PA Accel is to be a subject matter expert for...

Navitus Health Solutions is seeking a Manager, Government Clinical Services to join our Clinical Program Management department!    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...

Navitus Health Solutions is seeking a Sr. Manager, Enterprise Data Governance to join our Data department!    The primary responsibility will be implementing the Navitus Enterprise Data Governance operating model and creating and maintaining an accurate inventory of enterprise data assets for the organization. This role serves as the primary...

Navitus Health Solutions is seeking a Formulary Operations Specialist to join our Formulary Services department!   The Specialist, Formulary Operations will perform the daily, weekly, and monthly/periodic administrative functions necessary to update and maintain the formularies for Navitus’ clients for all lines of business. This includes working with the Formulary Services Supervisors to make all changes to the formulary information accessed by clients, as well as day to day formulary maintenance; and having advisory input to how this information is presented, maintained, and reviewed.  

Navitus Health Solutions is seeking a Scrum Master to join our team!   The Scrum Master ensures efforts are in alignment with customer-focused

Navitus Health Solutions is seeking a Software Developer II to join our team!   The Software Developer II 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 Software Developer IIs role is to define, develop, test, analyze, and maintain new and existing software applications in support of the achievement of business requirements. This includes designing, documenting, coding, testing, and analyzing software programs and applications. The Software Developer II will also research, design, document, and modify software...

Due to growth, we are adding a Enterprise Solutions Architect to our IT Enterprise Architecture department.    The Enterprise Solutions Architect is responsible for participating in the design, construction, maintenance, and enhancement of the Navitus IT infrastructure and...

Due to growth, we are adding an Analyst, Utilization Management to our Prior Authorization department. 

Due to growth, we are adding Provider Services Trainer to our team!     The Trainer, Provider Services is responsible for developing learning content, developing the departmental training portal, drafting training schedules, and completing the tactical and operational tasks required to meet the training needs of Provider Services team members.

Due to growth, we are adding  Sales Analyst to our Sales department!   The Sales Analyst supports the client acquisition and retention efforts of Navitus by providing professional and timely support to the Sales team while insuring the timely coordination and delivery of sales materials to key advisor relationships. The Sales Analyst participates in critical sales and marketing efforts. Among other job responsibilities, this position supports the maintenance, development, and distribution of a variety of sales collateral needs and works...