Navitus·1 day ago
1 day ago
Sr. Manager, Specialty Client Support (RPh)
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What you'll do
- Serve as a specialty pharmacy subject matter expert by translating complex specialty pharmacy, limited distribution drug, REMS, site-of-care, access, reimbursement, and related network concepts into clear, actionable recommendations.
- Participate in client meetings, quarterly business reviews, RFP support, and presentations as the specialty provider network expert through communicating network strategy and optimization opportunities.
- Advise on specialty network initiatives that support client goals, lowest-net-cost opportunities, member access, and organizational strategy.
- Oversee specialty client support processes, procedures, and service standards to ensure timely, accurate, and consultative responses to cross-functional inquiries involving access, claims, pricing, network configuration, and service concerns.
- Lead resolution of specialty pharmacy escalations by collaborating with internal teams to address network access, reimbursement, formulary, contract, and member issues.
- Manage specialty pharmacy client initiatives from ideation through implementation and ongoing enhancement, applying project management discipline to scope, resources, timelines, risks, dependencies, and stakeholder communications.
- Develop and maintain project plans, policies, procedures, work instructions, and scalable workflows that support client customization, operational consistency, regulatory compliance, and growth within specialty pharmacy service offerings.
- Support ongoing management of specialty pharmacy contracts to ensure contractual obligations and client-specific requirements are understood and met.
- Evaluate reimbursement pricing structures, network performance, vendor capabilities, market competitiveness, and industry developments to proactively recommend specialty network solutions.
- Collaborate with internal teams and external partners to expand network partnerships, refine specialty positioning, and support pharmacy services enhancements.
- Ensure all specialty pharmacy initiatives, client support activities, and implementation processes meet applicable corporate, compliance, Medicare, Medicaid, commercial, exchange, and state regulatory requirements.
- Manage a team of specialty client support staff, including hiring, performance, workload prioritization, and professional development.
What they're looking for
- PharmD degree or Bachelor’s degree from an accredited College of Pharmacy required.
- Current, unrestricted licensure as a Registered Pharmacist in the state of residence, or the ability to gain reciprocity within 4 months.
- 4+ years as a licensed Pharmacist required.
- 3+ years’ experience in leading and mentoring staff required.
- Experience of specialty pharmacy drugs including REMS and Limited Distribution Products best practices required.
Nice to have
- 1+ year of PBM or Managed Care experience preferred.
- Prior experience with managing vendors or accounts preferred.
- Product management/development or related experience preferred.
- Clinical experience in specialty pharmacy strongly preferred.
- Experience in the health, biomedical or pharmaceutical fields preferred.
- Experience with CMS, Medicare, and state Medicaid regulations and guidance preferred.
Summarised by NextRaise from the employer’s description, which follows in full below.
Full description from employer
Company
NavitusAbout Us
Navitus - 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._____________________________________________________________________________________________________________________________________________________________________________________________________________. Current associates must use SSO login option at https://employees-navitus.icims.com/ to be considered for internal opportunities. ____________________________________________________We are committed to providing equal employment opportunity to all applicants and employees and comply with all applicable nondiscrimination regulations, including those related to protected veterans and individuals with disabilities. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, or handicap.Pay Range
USD $124,140.34 - USD $155,175.42 /Yr.STAR Bonus % (At Risk Maximum)
15.00 - Sr Manager, NAE, Sr CAE IIWork Schedule Description (e.g. M-F 8am to 5pm)
M-F 8am to 5pmRemote Work Notification
ATTENTION: Navitus is 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.Overview
Navitus Health Solutions is seeking a Sr. Manager, Specialty Network Contracting to join our team!
The Sr. Manager, Specialty Client Support is responsible for providing specialty pharmacy clinical expertise, PBM operational insight, and client-facing guidance for Navitus specialty pharmacy services, specialty network strategy, and related network pharmacy contracting activities. This role oversees day-to-day clinical specialty client support, issue management, reporting, vendor coordination, and network strategy to ensure specialty products, client initiatives, and applicable network contracting activities are delivered on schedule, within scope, and in alignment with client, member, regulatory, and Navitus business needs. The role also provides leadership, training, and mentorship to specialty client support staff.
The Sr. Manager, Specialty Client Support requires strategic thinking, disciplined project management, and a comprehensive understanding of specialty pharmacy, PBM operations, pharmacy benefit design, claims processing concepts, network reimbursement, regulatory requirements, and lowest-net-cost strategies. Success in this role requires the ability to translate complex specialty network concepts into clear client recommendations, partner cross-functionally, and advance scalable solutions that support client satisfaction, member access, compliance, and corporate strategic objectives.
Is this you? Find out more below!
Responsibilities
How do I make an impact on my team?
- Serve as a specialty pharmacy subject matter expert by translating complex specialty pharmacy, limited distribution drug, REMS, site-of-care, access, reimbursement, and related network concepts into clear, actionable recommendations.
- Participate in client meetings, quarterly business reviews, RFP support, and presentations as the specialty provider network expert through communicating network strategy and optimization opportunities.
- Advise on specialty network initiatives that support client goals, lowest-net-cost opportunities, member access, and organizational strategy.
- Oversee specialty client support processes, procedures, and service standards to ensure timely, accurate, and consultative responses to cross-functional inquiries involving access, claims, pricing, network configuration, and service concerns.
- Lead resolution of specialty pharmacy escalations by collaborating with internal teams to address network access, reimbursement, formulary, contract, and member issues.
- Manage specialty pharmacy client initiatives from ideation through implementation and ongoing enhancement, applying project management discipline to scope, resources, timelines, risks, dependencies, and stakeholder communications.
- Develop and maintain project plans, policies, procedures, work instructions, and scalable workflows that support client customization, operational consistency, regulatory compliance, and growth within specialty pharmacy service offerings.
- Support ongoing management of specialty pharmacy contracts to ensure contractual obligations and client-specific requirements are understood and met.
- Evaluate reimbursement pricing structures, network performance, vendor capabilities, market competitiveness, and industry developments to proactively recommend specialty network solutions.
- Collaborate with internal teams and external partners to expand network partnerships, refine specialty positioning, and support pharmacy services enhancements.
- Ensure all specialty pharmacy initiatives, client support activities, and implementation processes meet applicable corporate, compliance, Medicare, Medicaid, commercial, exchange, and state regulatory requirements.
- Manage a team of specialty client support staff, including hiring, performance, workload prioritization, and professional development.
- Execute departmental strategic initiatives and continuous improvement efforts that improve specialty client satisfaction, operational efficiency, network quality, and service scalability.
- Participate in, adhere to, and support compliance, people and culture, and learning programs.
- Perform other duties as assigned.
Qualifications
What our team expects from you?
- Education: PharmD degree or Bachelor’s degree from an accredited College of Pharmacy required.
- Certification/Licenses: Current, unrestricted licensure as a Registered Pharmacist in the state of residence, or the ability to gain reciprocity within 4 months, may be required based on state of residence laws or client contracts. Refer to the Licensure and Credentialing Verification P&P for current detail.
- Experience:
- 4+ years as a licensed Pharmacist required.
- 3+ years’ experience in leading and mentoring staff required.
- 1+ year of PBM or Managed Care experience preferred.
- Experience of specialty pharmacy drugs including REMS and Limited Distribution Products best practices required.
- Prior experience with managing vendors or accounts preferred.
- Product management/development or related experience preferred.
- Clinical experience in specialty pharmacy strongly preferred; or a combination of training, education, and experience that is equivalent to the employment standard listed above.
- Experience in the health, biomedical or pharmaceutical fields preferred.
- Experience with CMS, Medicare, and state Medicaid regulations and guidance preferred.
What can you expect from Navitus?
- Top of the industry benefits for Health, Dental, and Vision insurance
- 20 days paid time off
- 4 weeks paid parental leave
- 9 paid holidays
- 401K company match of up to 5% - No vesting requirement
- Adoption Assistance Program
- Flexible Spending Account
- Educational Assistance Plan and Professional Membership assistance
- Referral Bonus Program – up to $750!
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