Program Manager, Client Services (Copay)
Trialcard Job In Morrisville, NC
Mercalis is an integrated life sciences commercialization partner that provides comprehensive solutions that span the entire healthcare value chain. Backed by proven industry expertise and results-driven technology, Mercalis helps navigate the complex life sciences marketplace by providing commercialization solutions to accelerate value and enhance patient lives.
Mercalis fosters a culture that encourages individuality and provides opportunities for creativity, growth, and success while fostering a team environment. We are a diversity-driven organization with an inclusive approach to delivering patient-centric solutions that, eliminate barriers for patients, and increase patient access to life altering medications.
As a Program Manager (PM), you will join our team on a journey to help eliminate barriers for patients, increase their access to medications, and help them receive lifesaving treatments while working in an environment that nurtures you.
The Program Manager, of Copay Programs, serves as the primary business relationship manager, is responsible for program management, account management, financial management and business analysis.
The PM will be responsible for providing excellent customer service, exceptional program management, in-depth program knowledge and operational excellence for their assigned brands. As the primary point of contact between our valued customers and Mercalis, PM serves a crucial role in driving internal project teams to deliver Mercalis' full suite of products and services on schedule, on budget, and within scope.
The ideal candidate must be a self-starter, high performer and able to embrace change in order to adapt within a fast growing organization.
Responsibilities
Manage client contracts / statements of work and execute accordingly, host and facilitate internal and client kick-off calls
Make recommendations to program strategies and roadmap offering the best solution for client projects in accordance with the SOW and in collaboration with the Director of Client Services
Gather and document business requirements and communicate changes, enhancements, and modifications - verbally or written - to clients, internal functional areas, sponsors, and other stakeholders so that business requirements and solutions are understood
Manage the program budget for the client and provide recommendations for effectively managing program cost
Interface with clients and maintain business essential relationships on a day-to-day basis as the primary business relationship manager
Conduct regular meetings (phone, webex, onsite) to update the client on program status, deliver presentations and provide an avenue for program enhancements
Become an expert on the therapeutic class of assigned brands and possess a robust understanding of competitive products utilized within the therapeutic class
Based on brands strategy, objectives and competitive landscape, be able to develop and implement innovative solutions for clients to maximize brand value and competitive positioning
Measure, and monitor program key performance indicators to develop data-driven recommendations
Learn and assist the client in navigating client-internal requirements and processes specific to their organization
Be well-versed on their third party service vendor landscape in order to manage and coordinate client vendor relationships (agencies, SPPs, HUBs, service providers, data/analytics teams)
Build and maintain healthy relationships with all internal functional areas, and take a leadership role with all internal project stakeholders
Be a sought out resource within Mercalis as both an internal and external subject matter expert
Provide mentorship and training to Associate Program Managers where needed
Perform other duties and assignments as directed
On time adherence to training deadlines for all corporate policies and procedures governing access to confidential data
Ensure all SOPs are followed with consistency Conducts miscellaneous tasks or projects as assigned
Position is remote with required occasional onsite visits
Qualifications
Bachelor's degree with a concentration in business, accounting, marketing and/or healthcare, or pharmaceutical industry, graduate degree and/or additional certifications including PMP preferred
Three to Four (3-4) years of project or program management experience
If an internal applicate, seeking extensive experience with Mercalis systems and services (preferred)
Exceptional communication skills, including verbal and written, ability to interact with internal and external stakeholders
Able to multi-task in a fast paced environment while functioning as a member of a highly collaborative team
Highly proficient in Microsoft Office (Project, Excel, PowerPoint, Visio, Word, Access, OneNote)
Organized and detail-oriented with effective time management skills
Budget management and/or financial accounting skills
Ability to take initiative and anticipate needs
Ability to travel both locally and out-of-town, expectation is up to 10% travel
Why work for Mercalis?
Diversity, Equity, Inclusion & Belonging are paramount to our culture and success. Our dedication to DEI is both organic and intentional
Our Mission is rewarding and fulfilling (Patient Access to Life-Saving/Improving/Extending Medications/Treatments)
We employ the best Talent and Tools from the Patient Access Industry (We are the Industry Leader)
We monitor the market to ensure we offer competitive salaries and benefits.
401K w/ 5% matching; day-1 vestment period
15 days PTO
8 Holidays + 2 Floating Days
Health/Dental/Vision/Life; Coverage Day-1
Gym Reimbursement
Volunteer Hours
*This is not an exhaustive list of benefits.
*Benefits are subject to change.
** Some positions require onsite presence and/or structured hours/shifts.
Institutional Sales Representative
Remote Trialcard Job
Through innovation, technology, and unparalleled customer service, Mercalis' passionate people provide patient-centric solutions to the pharmaceutical industry that improve access, affordability, and adherence to enhance patients' lives. We work tirelessly on the behalf of our clients, because when they succeed, so do we.
As a Virtual Engagement Institutional Specialty Representative (ISR), you will join our team on a journey to help eliminate barriers for patients, increase their access to medications, and help them receive lifesaving treatments while working in an environment that nurtures you.
We build personal, partner relationships with our clients by utilizing a consultative approach to solving brand challenges. The Virtual Engagement Institutional Specialty Representative provides education, disease awareness, and overviews of treatment options to healthcare providers in order to ultimately help patients improve the quality of life and treat or prevent diseases. ISRs are patient centric and purpose driven working remotely from a home office using equipment and technology supplied by Mercalis.
****Please note, this is a part-time (20 hours week) fully remote opportunity****
Responsibilities
A key objective will be the establishment of order sets, protocols and formulary position at targeted hospitals.
Generate and increase sales to achieve consistent performance against sales objectives for assigned institutions
Engage targeted customer audience in in-depth discussion of disease states and products using client approved materials
Contact HCPs via phone and computer technology to conduct virtual details
Schedule and conduct in-services with targeted HCPs within budget restraints and compliance regulations
Effectively use CRM system to gather all data and maintain metrics as well as continuity of ongoing engagement
Meet all specific program productivity metrics as set forth by the individual project
Manage daily call activity to optimize time and maximize sales objectives
Engage in active listening and respond appropriately to HCP needs and questions using conversational science skills
Successfully complete training to meet or exceed all expectations set by the client becoming an expert in the assigned disease and treatments
Fearless cold calling that can engage HCPs in conversation
Create and maintain a positive impression with the client, the HCPs, teammates, management and other Mercalis personnel
Manages effectively in uncertain and ambiguous situations.
Attend all necessary meetings, both virtually and in-person
Be a self-directed, resilient, decision maker who faces each task with optimism and is results oriented
Share best practices and successes with teammates and National Sales Manager
Competencies:
Driven to succeed (previous award winner)
Thinks and acts strategically
Accountable and reliable with strong integrity
Flexible and open to continuously learning
Self-motivated with a sense of purpose, passion, and persistence
Ability to perform the same tasks repeatedly without getting bored and staying goal oriented for the greater good of patients
Qualifications
Minimum 4+ years of pharmaceutical sales experience. Award winning performance
Minimum 2 years of Institutional Sales experience preferred
Excellent interpersonal, communication and presentation skills, verbal, written and digitally
Experience with salesforce.com or other CRM system
Strong technology skills including working knowledge of Microsoft Office products
Highly organized and detail-oriented
Strong time management and prioritization skills
Aptitude for detailed product knowledge and compliance adherence
Ability to resolve conflicting situations
High energy, collaborator with a positive attitude
Flexibility
Experience detailing HCPs using approved materials in a conversational manner
Tester, Benefit Configuration
Remote Job
Company Navitus About 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. Pay Range USD $19.60 - USD $21.26 /Hr. Work Schedule Description (e.g. M-F 8am to 5pm) M-F 8am to 5pm CST Remote Work Notification ATTENTION: Navitus is unable to offer remote work to residents of Alaska, Hawaii, Maine, Mississippi, New Hampshire, New Mexico, Rhode Island, South Carolina, South Dakota, West Virginia, and Wyoming. Overview
Navitus Health Solutions is seeking an Tester, Benefit Configuration to join our CAO Support department!
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 the integrity of pharmacy claims processing. Individuals in this role must use sound business judgement and demonstrate the ability to continually prioritize tasks, as customer experience and client financials are directly influenced by their quality of work.
This position may include after-hour and/or weekend hours with other eligible team members depending on workload.
Is this you? Find out more below!
Responsibilities
How do I make an impact on my team?
Completes scheduled and urgent benefit configuration testing of new client implementations and/or benefit additions, terminations, and changes timely and accurately to mitigate the risk of member access to care issues, missed performance guarantees and potential liquidated damages
Acquires and maintains a basic level of understanding of Navitus' claims adjudication system and upstream/downstream processes to test both standard and custom configurations to meet client expectations
Complies with standards set forth regarding benefit design and configuration testing including HIPAA, NCPDP and Navitus internal business standards
Uses departmental workflow management, issue resolution and reporting tools for troubleshooting and responding to general customer questions and issue resolution requests
Supports internal customers by participating in client meetings, audits, and new program implementations with other areas of the company, answering benefit testing questions and providing guidance to other areas and roles on the benefit configuration testing process
Conducts system enhancement and regression testing of a low to moderate level of complexity for benefit configuration processes to ensure compliance with state, federal and client regulations/standards
Contributes to training and maintains a mentoring relationship with new and existing benefit configuration testing team members
Other duties as assigned
Qualifications
What our team expects from you?
Associate degree or equivalent work experience
Basic experience with Microsoft Office, specifically Word and Excel
Participate in, adhere to, and support compliance program objectives
The ability to consistently interact cooperatively and respectfully with other employees
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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Location : Address Remote Location : Country US
Patient Care Coordinator
Remote or Los Angeles, CA Job
The VFP Pharmacy Group Patient Care Coordinator works under the direction of our Operations Supervisor to compassionately and efficiently assist patients, provider offices and clients via the telephone, email or chat. They are expected to process prescription claims including data entry into the pharmacy processing system and to adjudicate claims to payers. The PCC is also expected to answer and field questions from internal and external business partners via telephone and email. They will work to ensure VFP remains complaint, ethical, adherent to pertinent regulations and laws, and promotes an open, inclusive, and patient-centric culture. Daily tasks will include department tasks, workflow, aligned processes across all VFP locations (as needed). The PCC works closely with our Call Center Technicians and operates under the supervision of the clinical pharmacist teams.
Essential Functions
Delivers superior customer service and can work professionally in pharmacy environment
Interacts professionally with pharmacists, medical providers, consultants, and other staff
Accurately obtain and enter patient information, including shipping, insurance and payment information.
Entering Prescriptions into pharmacy operating system accurately via knowledge of medical terminology including sig codes and brand/generic medication. Other pharmacy terminology familiarity preferred
Responsible for identifying prescription errors and anomalies and escalating as necessary
Responsible for identifying and managing payer requirements within utilization and waste management with pharmacist assistance
Responsible for identifying prescription errors and anomalies and escalating as necessary
Responsible for identifying and managing payer requirements within utilization and waste management with pharmacist assistance
Exercises good team collaboration to ensure order timeliness, quality and service metrics are routinely achieved
Collaborates with members of health disciplines in the interest of the patient's health care
Refers patients to available resources in a timely manner
Brings a winning attitude to work each day
Other duties as assigned
Requirements and Preferences
High School Diploma or equivalent
California Pharmacy Technician License preferred
Must be available to work an 8-hour shift Monday through Friday, within the hours of 8:30am-6pm occasional holidays & rotating weekends
Minimum 1-3 years of call center experience, preferably in healthcare, insurance or specialty pharmacy setting
Strong working knowledge of HIPAA and other pertinent and applicable laws and regulations surrounding pharmacy and patient care
Strong technical knowledge of pharmacy processing system and phone systems
Ability to problem solve, think critically, and improve workflow procedures
Proven track record for handling large volume of inbound and outbound calls in a quality, compliant, and patient-centric fashion
Next-level compassion and empathy required to assist sensitive patient population
Ability to think holistically and continuous improvement mindset is essential
Excellent verbal and written communication skills required
Strong organizational skills, attention to detail and problem-solving skills
Ability to multi-task
Strong interpersonal, communication, and organizational skills required
Equal Opportunity Employer VFP Pharmacy Group is an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity, sexual orientation, national origin, ethnicity, age, disability, veteran status, marital status, or any other characteristic protected by law.
If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.
For this position, we anticipate offering an hourly rate of 17.75 - 19 USD / hourly, depending on relevant factors, including experience and geographic location.
This role is also anticipated to be eligible to participate in an annual bonus plan.
We want you to be healthy, balanced, and feel secure. That's why you'll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you'll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, visit Life at Cigna Group.
About Evernorth Health Services
Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Join us in driving growth and improving lives.
Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.
If you require reasonable accommodation in completing the online application process, please email: ********************* for support. Do not email ********************* for an update on your application or to provide your resume as you will not receive a response.
The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.
Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.
Intake Specialist I
Remote Job
Company Lumicera About Us Lumicera - Lumicera Health Services Powered by Navitus - Innovative Specialty Pharmacy Solutions- Lumicera Health Services is defining the "new norm" in specialty pharmacy to optimize patient well-being through our core principles of transparency and stewardship. Here at Lumicera, our team members work in an environment that celebrates creativity and fosters diversity.
Pay Range
USD $18.67 - USD $21.96 /Hr.
Work Schedule Description (e.g. M-F 8am to 5pm)
6am CST to 7pm, CDT
Remote Work Notification
ATTENTION: Lumicera is unable to offer remote work to residents of Alabama, Alaska, Connecticut, Delaware, Hawaii, Iowa, Kansas, Kentucky, Maine, Massachusetts, Mississippi, Montana, Nebraska, New Hampshire, New Mexico, Rhode Island, South Carolina, South Dakota, Vermont, West Virginia, and Wyoming.
Overview
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 for accurately translating prescription information and all other information obtained to dispense the medication into the pharmacy dispensing software. The Intake Specialist I may also be responsible for obtaining information and assisting providers and insurance companies in triaging prior authorizations for patients of the specialty pharmacy. The Specialty Pharmacist is accountable for verifying the prescription entry. This position will function with and assist any other area in the facility as needed regarding pharmacy technician type duties.
Is this you? Find out more below!
Responsibilities
How do I make an impact on my team?
* Responsible for placing phone calls to new and existing Specialty Pharmacy patients
* Responsible for enrolling patients into specialty services which may include, patient care management, copay assistance programs, and billing information
* Responsible for answering the inbound calls from patients, prescribers, and other healthcare professionals
* Responsible for contacting doctors to obtain necessary information
* Responsible for managing the assigned workflow queues
* Responsible for accurate and thorough documentation of information and prescription order set up
* The Employee will act in accordance with all applicable federal and state laws and with the highest ethical standards that we consistently strive to achieve. Thus, legal and ethical compliance is an essential duty of each employee
* Other duties as assigned
Qualifications
What our team expects from you?
* High school diploma or GED
* Some college preferred
* National CPhT and/or registration/licensure required per employee's residing state's requirements
* Minimum two years pharmacy support experience or healthcare environment experience preferred
* Ability to work scheduled hours, shifts may vary based on department needs. Hours of operation are 8am to 7pm Monday thru Thursday and 8am to 6pm on Friday
* Participate in, adhere to, and support compliance program objectives
* The ability to consistently interact cooperatively and respectfully with other employees
What can you expect from Lumicera? • 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
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Location : Address
Remote
Location : Country
US
Coordinator, Training and Development
Remote Job
Company Lumicera About Us Lumicera - Lumicera Health Services Powered by Navitus - Innovative Specialty Pharmacy Solutions- Lumicera Health Services is defining the "new norm" in specialty pharmacy to optimize patient well-being through our core principles of transparency and stewardship. Here at Lumicera, our team members work in an environment that celebrates creativity and fosters diversity.
Pay Range
USD $22.74 - USD $27.08 /Hr.
Work Schedule Description (e.g. M-F 8am to 5pm)
M-F 7:30am-5:30pm, CDT
Remote Work Notification
ATTENTION: Lumicera is unable to offer remote work to residents of Alabama, Alaska, Connecticut, Delaware, Hawaii, Iowa, Kansas, Kentucky, Maine, Massachusetts, Mississippi, Montana, Nebraska, New Hampshire, New Mexico, Rhode Island, South Carolina, South Dakota, Vermont, West Virginia, and Wyoming.
Overview
Due to growth we are adding a Coordinator, Training and Development to our team!
The Coordinator, Training and Development (TC) will deliver highly interactive, engaging, and impactful virtual instructor-led, instructor-led, web-conferenced, and video-conferenced training opportunities. The TC will support the ongoing efforts such as facilitating new hire orientations; coordinating, scheduling, and assisting ongoing training initiatives; resource and knowledge management; and regular marketing of the learning function. This person will utilize the corporate learning management system (LMS) to assign training and measure training success. This may include the development of online courses for use in the LMS. TC will readily adapt to incorporate projects and assignments as assigned. This is an entry level position that requires a growing knowledge of business operations, regulatory environment, and adult learning theory.
Is this you? Find out more below!
Responsibilities
How do I make an impact on my team?
* Provide initial and ongoing training for any employees in the organization as needed
* Facilitate new hire orientation programs from existing facilitator resources
* Ensure resources are utilized efficiently including RxVector, Lighthouse, NaviClaim, Compass, phone technology and others
* Coordinate onboarding activities for new hires, including scheduling new hire training sessions
* Coordinate with SMEs to schedule training initiatives, including employee development, and other training programs
* Coordinate, assign, and monitor training assignments
* Write and send regular communications including training announcements, monthly update emails, and feedback efforts to market the learning function
* Assist during file audits, including updating records, ad hoc reporting, and document review as needed
* Serve as site administrator for the onboarding portal to maintain and update onboarding materials, job aids, and checklists
* Other duties as assigned
Qualifications
What our team expects from you?
* Associates or bachelor's degree Preferred
* 2-years' experience as a successful customer care specialist or other experience in a quality-oriented position preferred
* Experience in hands-on training, course development and delivery, adult learning and evaluation methodologies preferred
* Intermediate to expert knowledge of MS Office Suite preferred
* Travel may be up to 20%, dependent on training at other campuses
* Participate in, adhere to, and support compliance program objectives
* The ability to consistently interact cooperatively and respectfully with other employees
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
#LI-Remote
Location : Address
Remote
Location : Country
US
Lead, Continuous Improvement
Remote Job
Company Navitus About 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. Pay Range USD $77,546.00 - USD $95,148.00 /Yr. Work Schedule Description (e.g. M-F 8am to 5pm) M-F 8am-5pm, CST Remote Work Notification ATTENTION: Navitus is unable to offer remote work to residents of Alaska, Hawaii, Maine, Mississippi, New Hampshire, New Mexico, Rhode Island, South Carolina, South Dakota, West Virginia, and Wyoming. Overview
Navitus Health Solutions is seeking a Continuous Improvement Lead to join our team!
The Lead, Continuous Improvement (CI) helps drive process excellence across the organization. The Lead, CI will be responsible for leading improvement projects using established process improvement methodology to positively impact and achieve sustainable results that support the organization's strategic plan. This position will serve as a continuous improvement project leader, mentor, and coach to ensure alignment with the organization's improvement approach. The Lead, CI must have the ability to effectively facilitate large groups of people in both project and learning environments and serve as a coach/mentor to all levels of the organization.
Is this you? Find out more below!
Responsibilities
How do I make an impact on my team?
Expertise in the practice of Lean and Six Sigma framework, including key tools used during implementation such as value stream mapping, 5S, statistical analysis, control charts, poke yoke, visual controls, and the DMAIC approach
Collaborates with sponsors and business owners to ensure projects are fully defined, including established objectives, schedules, customer expectations, scope, and ROI/cost avoidance targets
Ability to lead system-wide initiatives at any given time without any degradation in the quality of work performed
Lead the implementation of process improvement projects utilizing lean, DMAIC, and other continuous improvement methodologies to positively affect and achieve sustainable results
Develop the necessary project plans, as well as appropriate subproject plans, and lead the organization through the improvement process while adhering to the schedules and accomplishing set milestones
Help build awareness and socialization of Process Improvement methodologies and philosophies across the enterprise
Ability to work with key leaders and departmental staff to identify, secure, train/develop, and coach resources to achieve the initiative's short- and long-term goals
Develop, analyze, and verify requirements for completeness, consistency, and comprehensibility
Research, review, and analyze the effectiveness and efficiency of existing requirements-gathering processes and develop strategies for enhancing or further leveraging these processes
Other duties as assigned
Qualifications
What our team expects from you?
Bachelor's degree, or equivalent experience required in the field of Process Improvement
Certification in Lean or Six Sigma methodology required (blackbelt preferred)
Certification in Project Management, preferred
Certification in Change Management, preferred
5+ years' experience leading process improvement initiatives with demonstrated results
Demonstrated project management skills including business case and charter creation, comprehensive work breakdown structures, and inclusive implementation plans
Extensive experience with core software applications, including Microsoft Word, Excel, Visio, PowerPoint, and Project
Experience overseeing the design, development, and implementation of software solutions, systems, or products
Knowledge around the PBM industry preferred
Healthcare industry practices and HIPAA knowledge preferred
Familiarity with change management philosophies and practices preferred
Participate in, adhere to, and support compliance program objectives
The ability to consistently interact cooperatively and respectfully with other employees
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
#LI-Remote
Location : Address Remote Location : Country US
Pharmacist, Clinical Consultation
Remote Job
Company Lumicera About Us Lumicera - Lumicera Health Services Powered by Navitus - Innovative Specialty Pharmacy Solutions- Lumicera Health Services is defining the “new norm” in specialty pharmacy to optimize patient well-being through our core principles of transparency and stewardship. Here at Lumicera, our team members work in an environment that celebrates creativity and fosters diversity. Pay Range USD $98,384.00 - USD $122,980.00 /Yr. Work Schedule Description (e.g. M-F 8am to 5pm) Hours of Operation 8am-7pm CT M-TH; 8am-6pm CT F; This posting is for closing shift with possibility to move to earlier shifts as business needs allow Remote Work Notification ATTENTION: Lumicera is unable to offer remote work to residents of Alabama, Alaska, Connecticut, Delaware, Hawaii, Iowa, Kansas, Kentucky, Maine, Massachusetts, Mississippi, Montana, Nebraska, New Hampshire, New Mexico, Rhode Island, South Carolina, South Dakota, Vermont, West Virginia, and Wyoming. Overview
Due to growth we are adding a Clinical Consultation Pharmacist to our team!
The main duty of the Pharmacist, Clinical Consultation is to perform telephonic consultations with patients regarding the use of their specialty medication and management of their disease state. The Pharmacist, Clinical Consultation will perform medication reconciliation, screen for potential drug interactions, and provide side effect management recommendations. Additional tasks for this role include interpreting physicians' prescriptions, contacting prescribers for prescription clarification, and expediting the processing of orders. The individual in this position will be expected to meet department production metrics and service levels, support quality standards, resolve patient issues, and vary work priorities and activities to accommodate business needs. The Pharmacist, Clinical Consultation works independently with minimal guidance and represents the organization using patient-centered care to enhance the patient experience.
Is this you? Find out more below!
Responsibilities
How do I make an impact on my team?
• Provide patient education through telephonic consultations for patients of the specialty pharmacy in accordance with Lumicera's Patient Management Program. The consultations will focus on effective assessment and communication of disease state management, side effect mitigation strategies, administration of medication, appropriate storage, and therapeutic appropriateness, following patient-centered care model. Answer clinical questions from patients and caregivers.• Provide detailed clinical documentation of patient consultations and interventions in pharmacy software system in compliance with internal policies and procedures and external regulatory bodies (such as URAC).• Interpret and clinically evaluate prescriptions for specialty medications based on available information and resources. Contact providers and/or patients to verify information related to prescriptions such as drug strength, intended directions, and diagnosis to expedite processing of orders. Verify and confirm validity of controlled substances.• Contact physicians for new prescriptions, consult with physicians and nurses regarding pharmaceutical questions, and contact pharmacies for prescription transfers. Work with physicians to convert prescriptions to generic, biosimilar, or preferred drugs whenever possible. • Verify prescription information entered in the system by order entry. Answer clinical questions from the pharmacy team.• Adapt to new workflows and processes. Solve unique pharmaceutical problems. Stay current with advancements in specialty pharmacy therapies, including new drug approvals and specialty disease state treatment guidelines.• Back up other pharmacists as needed; train less experienced pharmacists.• Document and report medication errors per company policies and procedures. Facilitate error reduction and prevention methods based off quality department and ISMP standards.• Act in accordance with all applicable federal and state laws and with the highest ethical standards that we consistently strive to achieve. • Other duties as assigned Qualifications
What our team expects from you?
Education: Graduate of an ACPE Accredited School of Pharmacy with a B.S. Pharmacy or PharmD degree.
Certification/Licenses: Current, unrestricted pharmacist license in state of residence; must continually obtain education credits to maintain active licensure.
Experience:
At least two years of experience as a practicing licensed Pharmacist preferred.
Strong clinical background required.
Experience and/or strong understanding of Specialty Pharmacy medications desirable.
What can you expect from Lumicera?
• 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
#LI-Remote,
Location : Address Remote Location : Country US
Sr. National Account Executive
Remote Job
Company Navitus About 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. Pay Range USD $120,524.61 - USD $150,655.75 /Yr. Work Schedule Description (e.g. M-F 8am to 5pm) M-F 8am to 5pm CST Remote Work Notification ATTENTION: Navitus is unable to offer remote work to residents of Alaska, Hawaii, Maine, Mississippi, New Hampshire, New Mexico, Rhode Island, South Carolina, South Dakota, West Virginia, and Wyoming. Overview
Navitus Health Solutions is seeking a Sr. National Account Executive to join our Strategic Account Management department!
The Sr. National Account Executive (NAE) is a highly motivated professional with at least 10 years of successful experience interfacing directly with larger more complex clients in the managed healthcare arena. The Sr. NAE will lead strategy, overall service performance, and account service teams for existing PBM clients. The position is responsible for the co-development of long-term account strategy for the identified clients assigned to the team they support. This Sr.-level position will require the ability to communicate across multiple organizational levels; internal/external and the ability to lead specific office teams/projects. Additionally, the Sr. NAE will be responsible for direct management of the Sr. Client Services Executives (SCSE) and Client Service Executives (CSE) assigned to them along with supporting the management of the coordinators reporting up through the SCSEs. This includes mentoring, providing guidance, training, performance reviews, P&L Management, Budgeting, and other such managerial tasks. This position will also provide support to the team through participation in all strategic Client Consultative Reviews and Strategic Business Plan meetings and other client meetings as required.
Is this you? Find out more below!
Responsibilities
How do I make an impact on my team?
Manage and support the team of SCSEs, CSEs, SCSCs and CSCs assigned to them
Develop and manage Budget and P&L
Communicate effectively with Senior Team at Navitus and C-Suite externally
Support the creation and presentation of Strategic Business Plans, Consultative VALUE Summaries, and Performance Standard reports
Provide support and guidance relative to Performance Standards required
Responsible for reporting team metrics
Provide on-going formal training to team members
Manage hiring process and on-boarding process their team members
Travel to Client sites
Other duties as assigned
Qualifications
What our team expects from you?
Bachelor's degree in business, marketing, or related area
At least 10 years of successful experience interfacing directly with Managed Care clients including more sophisticated clients such as Health Plans or Managed Care companies
Managed Medicaid-specific experience is a plus
At least 5 years of direct team management experience
Participate in, adhere to, and support compliance program objectives
The ability to consistently interact cooperatively and respectfully with other employees
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
#LI-Remote
Location : Address Remote Location : Country US
Paralegal- Contracts-Hybrid- Madison WI
Remote or Madison, WI Job
Company Navitus About 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. Pay Range USD $28.11 - USD $33.87 /Hr. Work Schedule Description (e.g. M-F 8am to 5pm) M-F 8am-5pm Overview
This is a hybrid position in Madison WI.
Due to growth, we are adding a Paralegal to our Legal and Regulatory Affairs department!
This Paralegal role will report to the Assistant General Counsel -Contracts and support in drafting contracts and other legal documents for Navitus Health Solutions, LLC and its Subsidiaries. This role may also support Navitus, Lumicera, and their subsidiaries by (a) managing licensing processes; (b) drafting legal documents and templates, managing document templates and corporate legal records, performing records and legal research and preparing correspondence under general supervision; and (c) identifying, reviewing, and interpreting legislation and regulatory environment changes directly or indirectly impacting Navitus and provide support and analysis related to the interpretation and adoption of policies, processes, and procedures related to applicable regulations.
Is this you? Find out more below!
Responsibilities
How do I make an impact on my team?
Imparts the philosophy, values, mission, and vision of Navitus and SSM Health and facilitates the integration of values in Continuous Quality Improvement (“CQI”) activities
Manages processes related to licensing requirements for Navitus and its subsidiaries and their employees
Conducts legal search on relevant laws, statutes and regulations and prepares memorandums of the findings
Prepares legal documents, such as contracts and correspondence, for review, approval, and use by the attorneys
Files legal documents and correspondence in digital and physical filing systems
Ensures effective indexing and filing of legal documents
Researches and analyzes statutes, judicial decisions, legal articles, contracts, and legal codes
Performs other clerical duties such as scheduling appointments, providing information to internal and external stakeholders, taking notes, writing, and typing routine correspondence, and reading and triaging incoming mail. Identifying, reviewing, and tracking legislative and regulatory environment changes impacting Navitus and its affiliates
Provide support and guidance related to the interpretation of applicable rules and regulations
Other duties as assigned
Qualifications
What our team expects from you?
Secondary education and/or a paralegal certificate, or four or more years of comparable experience and/or training; or equivalent combination of education and experience
Previous drafting experience highly desired
Paralegal Certification preferred
Highly developed verbal and written communications skills to interact tactfully and effectively with others both internal and external to Navitus on sensitive and complex topics
Ability to type with speed and accuracy
Ability to use a personal computer and possess advanced skills in latest software programs such as Microsoft Word, Excel, Power Point, Outlook, Teams, and Adobe Acrobat
Organizational ability to plan work, prioritize assignments, and work with minimal supervision in a fast-paced tech-savvy work environment
Ability to solve problems and deal with a variety of situations where only limited standardization or information exists. Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form
Ability to adapt to new technology and new processes with minimal explanation
Participate in, adhere to, and support compliance program objectives
The ability to consistently interact cooperatively and respectfully with other employees
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
#LI-Hybrid
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.
Location : Address 361 Integrity Drive Location : City Madison Location : State/Province WI Location : Postal Code 53717 Location : Country US
Provider Services Support Specialist
Remote Job
Company Navitus About 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. Pay Range USD $52,656.00 - USD $62,686.00 /Yr. Work Schedule Description (e.g. M-F 8am to 5pm) M-F 8am-5pm, CST Remote Work Notification ATTENTION: Navitus is unable to offer remote work to residents of Alaska, Hawaii, Maine, Mississippi, New Hampshire, New Mexico, Rhode Island, South Carolina, South Dakota, West Virginia, and Wyoming. Overview
Due to growth we are seeking a Provider Services Support Specialist to join our Provider Services team!
The Provider Services Support Specialist is responsible for supporting Retail, Specialty and Mail initiatives in coordination with the Provider Services team. This position will be proficient in the analysis of Navitus claims and supplementary pharmacy data to support reporting and contract compliance. The Provider Services Support Specialist supports and evaluates agreements with providers and prospective clients via analysis, and reporting. This individual will also act as subject matter expert on pharmacy networks, programs and inquiries via the collection, processing, research, response and/or triage of requests and will represent the Provider Services Department in all client meetings, as applicable. The Provider Services Specialist, under the direction and supervision of Provider Services leadership, is responsible for evaluating pharmacy participation agreements to maximize pharmacy discounts in a consulting capacity with current and new Navitus clients. The position will support internal and client provider services communications, service inquiry responses, and program requirements with clients and pharmacy partners to ensure Navitus is meeting applicable program obligations. The individual will be expected to understand and interpret data, including claims utilization from Navitus' data warehouse and from NCRx, formulary files, pharmacy network databases, NCPDP pharmacy files, Medispan files, and other databases required from time-to-time to facilitate and ensure the accurate delivery of information related to client and pharmacy partner reporting requirements. This position will also support Navitus client inquiries regarding contractual issues, including internal and external contacts regarding pharmacy participation, pharmacy services, and network discounts.
Is this you? Find out more below!
Responsibilities
How do I make an impact on my team?
Primary resource within department for Retail, Specialty, and Mail pharmacy opportunities, client requests for potential network opportunity evaluations, and assists teams in evaluation and assessments of current clients' pharmacy network performance, current industry trends, performance, and initiatives
Serve as the primary representative for Provider Services during new client implementation, including the review and refinement of existing processes
Ability to read and interpret Network contracts to facilitate Network design recommendations for clients
Review and analyze Navitus claims data and clinical data from Retail, Mail and Specialty pharmacy partners to develop and improve pharmacy reporting packages for Navitus departments and clients
Coordination with pharmacy partners to ensure contractual compliance with terms of Specialty pharmacy contracts including performance guarantees, financial and services terms
Responsible for the use of databases to generate pharmacy reports for clients, pharmacies, and internal customers, and identification of ways to improve and/or automate generation of these reports
Research customer and contract issues that may affect account planning, strategies, and proposals
Continually monitor pharmacy network programs to meet all government regulations and statutes, and client guarantees in performance of our services
Other duties as assigned
Qualifications
What our team expects from you?
Bachelor's degree is required with concentration in Business preferred
Two-three years business experience in a related industry (pharmacy or PBM) is preferred
Pharmacy technician certification is a plus
At least 1 year experience in business, finance or economics is preferred
Participate in, adhere to, and support compliance program objectives
The ability to consistently interact cooperatively and respectfully with other employees
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.
Location : Address Remote Location : Country US
Sr. Pharmacy Sales Representative
Remote Job
Company Lumicera About Us Lumicera - Lumicera Health Services Powered by Navitus - Innovative Specialty Pharmacy Solutions- Lumicera Health Services is defining the “new norm” in specialty pharmacy to optimize patient well-being through our core principles of transparency and stewardship. Here at Lumicera, our team members work in an environment that celebrates creativity and fosters diversity. Pay Range USD $93,672.00 - USD $114,934.00 /Yr. Work Schedule Description (e.g. M-F 8am to 5pm) M-F 8am-5pm, CST Remote Work Notification ATTENTION: Lumicera is unable to offer remote work to residents of Alabama, Alaska, Connecticut, Delaware, Hawaii, Iowa, Kansas, Kentucky, Maine, Massachusetts, Mississippi, Montana, Nebraska, New Hampshire, New Mexico, Rhode Island, South Carolina, South Dakota, Vermont, West Virginia, and Wyoming. Overview
Lumicera Health Services is seeking a Sr. Pharmacy Sales Representative to join our team!
The Sr. Pharmacy Sales Representative is a customer-oriented pharmacy sales representative who can thrive and a fast-paced environment and will manage and assist the entire scope of the sales process for new Lumicera Health Services business in the California market. The Sr. Pharmacy Sales Representative will work with the Pharmacy Sales Director to execute market strategies for a market segment. The Sr. Pharmacy Sales Representative will act as the link between our company and healthcare professionals, with the goal to increase the visibility and awareness of our company's high value offerings to clinicians and maximize sales growth. Key contacts will include prospective clinics, manufacture partners, and key client relationships. The Sr. Pharmacy Sales Representative must contribute to multi-functional team efforts; Further, the individual must understand and effectively communicate all portions of the business to all internal and external stakeholders.
Is this you? Find out more below!
Responsibilities
How do I make an impact on my team?
Work with the Pharmacy Sales Director to execute market strategies for the designated market segment
Responsible for all phases of the sales process through leads and follow-ups
Participate In development of combined market segment and geographic plan
Participate in identifying the profile of clinics that can most benefit from a relationship with Lumicera and the market research to identify those that are best aligned to the profile
Internal sales project team leadership
Identify, manage discovery and presentation of solution, and negotiation
Report Sales Activities to Pharmacy Sales Director with respect to: Sales Pipeline, Status of projects and ‘cases', Prospective clinic strategies, and Assessment of other market team efforts
Travel to regional prospective clinic sites up to 60% of time
Participate in business events, conferences, trade shows and seminars, supporting our marketing efforts as needed
Other duties as assigned
Qualifications
What our team expects from you?
A minimum of a bachelor's degree or multiple years of equivalent/relevant experience
Proven work experience as a sales rep or in medical sales
Specialty Pharmacy or pharmaceutical sales experience is strongly preferred
Participate in, adhere to, and support compliance program objectives
The ability to consistently interact cooperatively and respectfully with other employees
What can you expect from Lumicera? • 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 #LI-RemoteLocation : Address Remote Location : Country US
Medication Procurement Supervisor
Remote Job
Company Lumicera About Us Lumicera - Lumicera Health Services Powered by Navitus - Innovative Specialty Pharmacy Solutions- Lumicera Health Services is defining the "new norm" in specialty pharmacy to optimize patient well-being through our core principles of transparency and stewardship. Here at Lumicera, our team members work in an environment that celebrates creativity and fosters diversity.
Pay Range
USD $61,968.00 - USD $74,660.00 /Yr.
Work Schedule Description (e.g. M-F 8am to 5pm)
M-F 8am-5pm, CST
Remote Work Notification
ATTENTION: Lumicera is unable to offer remote work to residents of Alabama, Alaska, Connecticut, Delaware, Hawaii, Iowa, Kansas, Kentucky, Maine, Massachusetts, Mississippi, Montana, Nebraska, New Hampshire, New Mexico, Rhode Island, South Carolina, South Dakota, Vermont, West Virginia, and Wyoming.
Overview
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!
Responsibilities
How do I make an impact on my team? • Establish inventory management best practices while ensuring sufficient supply of product to meet the needs of each location.• Develop strategies to support with vendor selection and facilitate appropriate procurement of product by operations staff based on lowest net cost pricing.• Support in negotiating indirect and direct purchasing agreements with manufacture partners.• Maintain and enhance professional relationships with primary and secondary wholesaler vendors.• Facilitate in the management of the wholesale Request for Proposal process and analyze data to reflect awards with each vendor.• Support development of compelling marketing content and support creative design efforts to drive company and brand awareness through industry publications, media, and appropriate public relations opportunities.• Contribute to the department goal of improved efficiency and effectiveness, including the capture of strategic client opportunities using approved reference resources that support proposal and presentation development activities.• Other duties as assigned
Qualifications
What our team expects from you? • Bachelor's degree required, preferably in Business Administration, a Communications-related field, and/or Account Management.• 5 years of experience within a healthcare setting participating or managing inventory.• 2+ years of direct or indirect supervisory/management and/or coaching and mentoring experience required.• 5 years of experience developing and implementing complex winning business strategies, while incorporating a consultative-sales approach.• 5 years of experience delivering quality outputs in a fast-paced and dynamic team environment where tight time frames and strict deadlines are the norm.• 5 years of experience in strategic business development and project management experience or similar related experience.• 5 years of experience in proficient utilization of PC in both spreadsheet and word processing desktop environment including software applications including Microsoft products.• Participate in, adhere to, and support compliance program objectives • The ability to consistently interact cooperatively and respectfully with other employees
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
#LI-Remote
Location : Address
Remote
Location : Country
US
Program Director, Market Access
Trialcard Job In Morrisville, NC
Mercalis is an integrated life sciences commercialization partner that provides comprehensive solutions that span the entire healthcare value chain. Backed by proven industry expertise and results-driven technology, Mercalis helps navigate the complex life sciences marketplace by providing commercialization solutions to accelerate value and enhance patient lives.
Mercalis fosters a culture that encourages individuality and provides opportunities for creativity, growth, and success while fostering a team environment. We are a diversity-driven organization with an inclusive approach to delivering patient-centric solutions that, eliminate barriers for patients, and increase patient access to life altering medications.
As a Director of Client Services, you will join our team on a journey to help eliminate barriers for patients, increase their access to medications, and help them receive lifesaving treatments while working in an environment that nurtures you.
The Director of Client Services leads a team of program managers within the Client Services Department with the objective of delivering exceptional service to Mercalis' pharmaceutical manufacturer customers. The Director of Client Services will lead their team with consistent coaching, regularly providing specific and actionable feedback to strengthen the individual and team's performance. The Director of Client Services is responsible for driving the account strategy for assigned customers. This individual is also responsible for serving as the first point of escalation, both for customers and for internal conflicts or prioritization of resources. Finally, this individual will maintain operational oversight of programs to ensure services and solutions are delivered successfully and meeting client expectations.
Responsibilities
Lead, develop, and train a team of program managers in delivering exceptional customer service to Mercalis' customers
Utilize Mercalis; leadership competencies as the driving force behind the team's success
Teach, coach, and mentor program managers as their primary trainer upon hire and on an ongoing basis
Conduct regular one-on-one meetings with direct reports
Position self as a senior Mercalis resource for assigned customers
Serve as the first point of escalation for customer issues; inform manager (VP, Client Services) of customer escalations
Breakdown barriers that prevent program managers from being able to operate effectively
Manage internal issues or conflicts as the first point of escalation; resolve all issues peer-to-peer at the lowest possible level
Review all scoping requests, pricing, and SOWs for accuracy prior to delivery to customers
Drive contract renewal process to ensure contracts are signed prior to expiration dates of programs
Review all significant client deliverables (e.g., QBR slides, etc.) prior to delivering to customers
Maintain oversight of program scope, budgets, and spend and ensure amendments or change orders are executed, as appropriate
Work with program manager and sales team to expand current business and identify upsell opportunities
Maximize customer retention and mitigate revenue loss by driving account strategy and operational excellence for all assigned customers
Ensure no business loss due to personal negligence, mismanagement, or execution-related issues by client services team
Display Mercalis commitment by reaching out periodically to clients to gauge their satisfaction both with the assigned program manager and the program
Develop best practices, routines, and tools for program management
Build and maintain strong operational relationships with other Mercalis departments
Qualifications
Why work for Mercalis?
Our Mission is rewarding and fulfilling (Patient Access to Life-Saving/Improving/Extending Medications/Treatments)
We employ the best Talent and Tools from the Patient Access Industry (We are the Industry Leader)
We monitor the market to ensure we offer competitive salaries and benefits.
401K w/ 5% matching; day-1 vestment period
15 days PTO
8 Holidays + 2 Floating Days
Health/Dental/Vision/Life; Coverage Day-1
Gym Reimbursement
Volunteer Hours
*This is not an exhaustive list of benefits.
*Benefits are subject to change.
** Some positions require onsite presence and/or structured hours/shifts.
Clinical Liaison
Remote Job
Company Lumicera About Us Lumicera - Lumicera Health Services Powered by Navitus - Innovative Specialty Pharmacy Solutions- Lumicera Health Services is defining the “new norm” in specialty pharmacy to optimize patient well-being through our core principles of transparency and stewardship. Here at Lumicera, our team members work in an environment that celebrates creativity and fosters diversity. Pay Range USD $19.60 - USD $23.06 /Hr. Work Schedule Description (e.g. M-F 8am to 5pm) M-F 7am to 7pm Remote Work Notification ATTENTION: Lumicera is unable to offer remote work to residents of Alabama, Alaska, Connecticut, Delaware, Hawaii, Iowa, Kansas, Kentucky, Maine, Massachusetts, Mississippi, Montana, Nebraska, New Hampshire, New Mexico, Rhode Island, South Carolina, South Dakota, Vermont, West Virginia, and Wyoming. Overview
Due to growth, we are adding a Clinical Liaison to our Specialty Pharmacy Operations department.
The Clinical Liaison will focus on integrating patient care and clinical coordination while leading the development, implementation and ongoing monitoring of programs and initiatives between to clinics and Lumicera Health Services.
Is this you? Find out more below!
Responsibilities
How do I make an impact on my team?
Work with both clinical and administrative departments to create a collaborative and professional relationship on behalf of Lumicera Health Services and SSM Specialty Pharmacy
Serves as the liaison between the medical staff, outpatient pharmacies, insurance providers and patients to improve communication and continuity of care
Communicate current and relevant prescription, insurance, and financial needs as they relate to appropriate pharmacists, providers, clinical support staff and patients
Coordinate and support educational activities as requested
Interacts with clinic employees, including but not limited to pharmacists, clinical staff, fiscal personnel, department managers, access services staff, coding staff, and billing assistants. External contacts include but are not limited to third party payers, manufacturers, prescription benefit management companies, external pharmacy personnel, and referring providers and their support staff
The Employee will act in accordance with all applicable federal and state laws and with the highest ethical standards that we consistently strive to achieve. Thus, legal and ethical compliance is an essential duty of each employee
Other duties as assigned
Qualifications
What our team expects from you?
High school diploma or GED, some college preferred
CPhT preferred
Minimum of two years pharmacy support experience or healthcare environment experience preferred
Ability to work scheduled hours, shifts may vary based on department needs. Hours of operation are 8am to 7pm Monday thru Thursday and 8am to 6pm on Friday
Participate in, adhere to, and support compliance program objectives
The ability to consistently interact cooperatively and respectfully with other employees
What can you expect from Lumicera?
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!
#LI-Remote
Location : Address Remote Location : Country US
Reimbursement Case Manager
Trialcard Job In Morrisville, NC
Mercalis is an integrated life sciences commercialization partner that provides comprehensive solutions that span the entire healthcare value chain. Backed by proven industry expertise and results-driven technology, Mercalis helps navigate the complex life sciences marketplace by providing commercialization solutions to accelerate value and enhance patient lives.
Mercalis fosters a culture that encourages individuality and provides opportunities for creativity, growth, and success while fostering a team environment. We are a diversity-driven organization with an inclusive approach to delivering patient-centric solutions that, eliminate barriers for patients, and increase patient access to life altering medications.
As a Reimbursement Case Manager, you provide inbound and outbound phone support and serve as the primary contact for patients, caregivers, and providers. You will facilitate a collaborative process that gauges, coordinates, and monitors patient needs and appropriately facilitate a patient's journey utilizing services offered through the Patient Support Program on behalf of a manufacturer. The primary function is to provide unparalleled customer service to patients, caregivers and providers as a dedicated contact by coordinating resources, exchanging information and ensuring appropriate delivery of services. These services include handling the day-to-day activities within reimbursement services, such as daily interactions with healthcare insurance companies to verify the financial aspects of healthcare services to ensure patients have access to life saving treatments they need.
Responsibilities
Reimbursement Case Managers may be regionally aligned and will serve as an expert on reimbursement, co-pay, foundation assistance, PAP issues, and other forms of available support and will be responsible for handling patient and healthcare provider interactions
Serve as an advocate to patients regarding eligibility requirements, program enrollment, reimbursement process, affordability support, and general access for prescribed therapy
Establish relationships, develop trust, and maintain rapport with patients, payers and healthcare providers
Serve as direct point of contact to health care providers for ongoing support and relationship development by acquiring and delivering detailed information regarding a program and/or a patient
Serve as a resource for patients and healthcare professionals to verify insurance coverage, medical billing, reimbursement process, and general access for complex pharmaceuticals
Evaluate program enrollment forms for data integrity
Responsible for insurance benefit investigations, and triage cases according to program standard operating procedures
Follow program guidelines and escalate complex cases according to program policy, SOPs, Call Guides, and other program materials.
Working case management system, documenting status/background in case notes, communicating patient benefits, assisting in the PA/Appeals process and like responsibilities
· Ability to understand and explain benefits offered by all payer types including private/commercial and government (i.e., Medicare, Medicaid, VA and DOD)
· Act as an assigned liaison to client contacts (e.g., regional contact for sales representatives), Program Management, other internal stakeholders and Healthcare Providers
Maintain records in accordance with applicable standards and regulations to the programs/promotions
· Provide unparalleled customer service while serving as a brand advocate and program representative; understands the importance of achieving quality outcomes and commit to the appropriate use of resources
Works with the Program Manager, on a day-to-day basis to maintain open lines of communication and share awareness regarding patient status, prescriber feedback/satisfaction and program effectiveness
Understand health and disease states of patients of the programs
Maintains a high level of ethical conduct regarding confidentiality and privacy
Help maintain team morale by consistently demonstrating positive attitude
· On time adherence to training deadlines for all corporate policies and procedures governing access to confidential data
· Ensure all SOPs are followed with consistency
· Conducts miscellaneous tasks or projects as assigned Identify and report pharmacovigilance information as required by client(s) (i.e., Adverse Events) - (specific to program/client requirements)
Qualifications
Associate or Bachelor's degree preferred; or a minimum of 4 years of call center or customer service experience with progressive levels of responsibility within a service driven environment
Ability to communicate effectively both orally and in writing
Knowledge of medical insurance terminology and reimbursement/insurance, healthcare billing, physician office, health insurance processing or related experience
Excellent problem-solving and decision-making skills required
Attention to detail and committed follow through in communication with patients, providers and internal stakeholders
Strong organizational skills
Willing to work in a dynamic, fast paced environment and have the ability to multi-task and adapt to change while adhering to Program Standards
Strong interpersonal skills, ability to work both independently and as part of a team,ability to jump in and help others as needed
Empathetic listening skills in order to interact effectively with patients and providers
Punctual, reliable with strong attendance record
Proficient with Microsoft products
Why Work for Mercalis?
Mercalis fosters a culture that encourages individuality and provides opportunities for creativity, growth, and success while fostering a team environment. We are a diversity-driven organization with an inclusive approach to delivering patient-centric solutions that, eliminate barriers for patients, and increase patient access to life altering medications.
Our Mission is rewarding and fulfilling (Patient Access to Life-Saving/Improving/Extending Medications/Treatments)
We employ the best Talent and Tools from the Patient Access Industry (We are the Industry Leader)
We monitor the market to ensure we offer competitive salaries and benefits.
401K w/ 5% matching; day-1 vestment period
15 days PTO
8 Holidays + 2 Floating Days
Health/Dental/Vision/Life; Coverage day-1
Gym Reimbursement
Volunteer Hours
Flexibility/Hybrid/Remote**
Medicare Services Executive- MST-remote
Remote Job
Company Navitus About 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. Pay Range USD $65,686.00 - USD $79,140.00 /Yr. Work Schedule Description (e.g. M-F 8am to 5pm) Monday-Friday 8:00am to 5:00pm Remote Work Notification ATTENTION: Navitus is unable to offer remote work to residents of Alaska, Hawaii, Maine, Mississippi, New Hampshire, New Mexico, Rhode Island, South Carolina, South Dakota, West Virginia, and Wyoming. Overview
Navitus Health Solutions is seeking a Medicare Services Executive to join our Government Programs department's West Coast team!
Our ideal candidate sits in Mountain or Pacific time zone.
The Medicare Services Executive (MSE) is a highly motivated professional with at least 3 years of successful experience interfacing directly with clients that provide Medicare Part D services to their members. The position is responsible for the co-development of long-term account strategy for their assigned Clients. Working with subject matter experts, the MSE will be responsible for delivering Medicare Part D guidance and tracking all Medicare Part D specific projects and issues.
The MSE will support retention efforts with the Client Services Executive through the achievement of corporate strategic goals relative to the client base and overall customer satisfaction. Efforts include solving client Medicare Part D issues relative to their delegated services, reporting, and will interface with the Clinical Account Executive for clinical issues. This position will require the ability to communicate across multiple organizational levels and the ability to lead projects is required.
Is this you? Find out more below!
Responsibilities
How do I make an impact on my team?
Serves as primary Medicare Part D Point of Contact for the client
Support the Lead Client Services Executive with Strategic Business Plans and Medicare Part D VALUE Summaries
Provide Final Rule, Call Letter, Technical Specification and/or HPMS Memo updates to clients to include, interpretations, progress of enhancement efforts, answer client questions and facilitate and complete client requests
Assists the Client Services Executive in the evaluation of unmet Medicare Part D Performance Guarantees and responses provided to clients
Serves as Liaison to the Client and Project Leader for annual re-implementations
Creates the benefit matrixes required to describe and communicate the Plan Sponsors' Medicare products and provides to all business units supporting the annual re-implementations
Supports the Program Manager and Implementation Team on new client implementations
Engages the Program Management team and Audit team with all non-compliance related issues
Assists the Medicare Part D Program Manager with Contract and Scope Definition Document maintenance
Attends Client Facing Value Summaries at least twice annually, providing overviews of projects, compliance, and annual re-implementation efforts
Other duties as assigned
Qualifications
What our team expects from you?
Bachelor's degree in business, marketing, healthcare, or related area required.
At least 3 years of successful experience interfacing directly with clients required.
Knowledge of PBM or health care industry required.
At least 2 years of knowledge of Medicare Part D is required.
Strategic thinking ability and skills to prepare business plans and execute them appropriately to accomplish business objectives.
Customer-Centric Skills, and ability to understand internal and external customers.
Ability to work independently and prioritize work in order to meet client needs.
Strong team orientation, commitment to sales and client service, and desire to succeed.
Willingness to travel as needed to meet goals.
Excellent verbal and written communication, presentation and negotiation skills required.
PC skills; Microsoft Office, Email, and Internet.
Ability to take initiative in job responsibilities.
Our ideal candidate sits in Mountain or Pacific time zone.
What can you expect from Navitus?
Top of the industry benefits for Health, Dental, and Vision insurance
Analyst II, Compliance
Remote Job
Company Navitus About 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. Pay Range USD $55,151.00 - USD $66,447.00 /Yr. Work Schedule Description (e.g. M-F 8am to 5pm) M-F 8am-5pm, on-call weekends Remote Work Notification Hidden (38926) Overview
Navitus Health Solutions is seeking a Compliance Analyst II to join our Compliance department!
The Analyst II, Compliance position is responsible for organizing aspects of the Navitus and Lumicera Corporate Compliance and HIPAA Privacy Programs. In addition, the Analyst II is responsible for performing regularly scheduled policy, risk assessment and documentation reviews to ensure adherence with HIPAA Privacy and other regulatory compliance areas. The Analyst II will coordinate breach and disclosure assessment, HHS OCR reporting, tracking and client reporting. The Analyst will remain current on HIPAA Privacy and regulatory compliance environment changes directly or indirectly impacting Navitus or Lumicera. The Analyst II will also assist the Senior Manager, Compliance and SIU with duties related to privacy, compliance committee, metrics calculation and reporting of results. The Analyst II works closely with the Regulatory Affairs, SIU, IT and all key functional departments to ensure and measure the quality and integrity of work product and eliminate/reduce re-work. The Analyst II will assist with FWA activities, as needed. In addition, the Analyst II has responsibility for supporting and preparing documentation for compliance-related audits and identifying issues adversely impacting the respective process. The Analyst II will follow through on deliverables and assignments timely with no prompting. Reporting shall be done by preparing written report and providing and facilitating recommendations for corrective action and process improvement. This role requires strong knowledge of both the technical and operational sides of the business.
Is this you? Find out more below!
Responsibilities
How do I make an impact on my team?
Leads the investigation, resolution, and documentation of privacy issues, privacy breaches and disclosures consistent with government reporting and client contractual requirements
Assist the Compliance and SIU Manager with duties and presentation of information related to privacy, compliance committee, policy and procedure evaluation and monitoring, other compliance activities, audits and reporting of results
Ensure tracking and monitoring of compliance documentation, policies, versions, and reviews including availability on Compass, timely completion, and consistent classification
Assists SIU as deemed necessary with activities such as the OIG/EPLS exclusion program, policy and procedure maintenance, investigation support, and FWA education, etc
Prepare written analysis of findings and communicate recommendations for corrective action and process improvement
Supports, facilitates, and develops compliance education and awareness efforts, documentation, and educational content development
Responds to and facilitates corporate compliance guidance research, interpretation and clarification as requested and appropriate along with preparation of cited documentation
Facilitates and/or participates in process re-design, service improvement, cost reduction and automation including work instructions and forms with minimal editing needed
Assists in compliance and privacy risk analysis process
Other duties as assigned
Qualifications
What our team expects from you?
A minimum of a Bachelor's Degree is required. Privacy or compliance certification or designation required. A combination of education, certification and relevant work experience may substitute the degree requirement
2-4 years in a role with direct responsibility of privacy and/or compliance duties
Knowledge of state and federal privacy laws required
Participate in, adhere to, and support compliance program objectives
The ability to consistently interact cooperatively and respectfully with other employees
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 #LI-RemoteLocation : Address Remote Location : Country US
Software Engineer
Remote Job
Company Navitus About 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.
Pay Range
USD $98,383.00 - USD $122,979.00 /Yr.
Work Schedule Description (e.g. M-F 8am to 5pm)
M-F 8am to 5pm
Remote Work Notification
ATTENTION: Navitus is unable to offer remote work to residents of Alaska, Hawaii, Maine, Mississippi, New Hampshire, New Mexico, Rhode Island, South Carolina, South Dakota, West Virginia, and Wyoming.
Overview
Due to growth, we are adding a Software Engineer to 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 continually look for creative ways to stretch the boundaries and challenge the norms. This position will take an open-minded approach to technology and embrace the culture of Innovation at Navitus. As a Software Engineer, having a creative vision & continually thinking of the many ways a problem can be solved, is a must.
The ideal candidate will have experience using AWS event driven architecture using a serverless architecture pattern and strong knowledge of AWS topology and Infrastructure as Code (IaC) principles.
Is this you? Find out more below!
Responsibilities
How do I make an impact on my team?
* Collaborate with analysts, developers, programmers, and designers in conceptualizing and development of software programs and applications
* Design, develop, document, and implement new applications and application enhancements according to business and technical requirements
* Recommend, schedule, and perform software improvements and upgrades
* Consistently design, write, translate, and code software programs and applications according to specifications
* Write new and modify existing programming scripts to enhance functionality and/or performance of company applications as necessary
* Design, run and monitor software performance tests on new and existing programs for the purposes of correcting errors, isolating areas for improvement, and general debugging
* Develop and maintain technical documentation and development guidelines
* Full Stack Development experience leveraging Event Driven Architecture in a serverless architecture pattern, lambdas, cloudformation/CDK, cloudwatch, step functions, RDS/PostGreSQL, Oracle, C#, .NET, JavaScript, Python, Typescript
* Other duties as assigned
Qualifications
What our team expects from you?
* College degree (2- or 4-year program) typically in the field of computer science, information systems or software engineering
* Must have 6+ years of professional development experience in full stack development leveraging Event Driven Architecture in a serverless architecture pattern, lambdas, cloudformation/CDK, cloudwatch, step functions, RDS/PostGreSQL, Oracle, C#, .NET, JavaScript, Python, Typescript
* Extensive knowledge of source control tools such as TFS and GitHub
* Proven experience collaborating with business teams to analyze business requirements and develop technical specifications
* Demonstrated paired programming and Agile Scrum
* Demonstrated understanding of Software Development Life Cycle
* Healthcare industry practices and HIPAA knowledge would be a plus
* The ability to consistently interact cooperatively and respectfully with other employees
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!
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.
#LI-Remote
Location : Address
Remote
Location : Country
US
Compounding Pharmacy Technician - Freedom Fertility
Remote or Massachusetts Job
As a Compounding Pharmacy Technician, you will be working on a specialized team focused on high touch programs to assist our patients. This role is detail oriented and you will spend the majority of your day working in our compounding suite, compounding sterile and non-sterile medication, completing daily documentation as required per USP regulations, maintaining the compounding suite, entering formulas in the compounding software.
A little more about the day-to-day:
Compound sterile and nonsterile medication orders
Cleaning and maintaining compounding suite equipment and facilities
Ensuring proper labeling, packaging, and storage of chemicals and finished products
What you need to do the job:
High School Diploma, or GED
MA State Pharmacy Technician License required; National technician certification preferred
Microsoft Office proficiency and data entry skills
Exceptional attention to detail, accuracy and quality
Excellent verbal and written communication skills
Work Schedule: 9 AM to 5:30 PM EST - Monday through Friday
For positions that are Worksite Dependent:
This role is Worksite dependent and can only be performed onsite.
Why Cigna?
Day 1 medical insurance
401(k) plan with employer match
Paid Time Off
Competitive Benefit package
Growth and Advancement opportunities
If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.
About Evernorth Health Services
Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Join us in driving growth and improving lives.
Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.
If you require reasonable accommodation in completing the online application process, please email: ********************* for support. Do not email ********************* for an update on your application or to provide your resume as you will not receive a response.
The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.
Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.