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Navitus Health Solutions

Director, Clinical Strategy (RPh)

Posted Yesterday
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Remote
Hiring Remotely in United States
152K-190K Annually
Senior level
Remote
Hiring Remotely in United States
152K-190K Annually
Senior level
Leads enterprise formulary, utilization management, and clinical business development strategy for a pharmacy benefit manager. Oversees formulary decisions, drug pipeline monitoring, prior authorization criteria, P&T governance, regulatory alignment, budgeting, client pursuits, and cross-functional teams. Provides clinical leadership, supervises multiple teams, and ensures strategies improve patient outcomes, manage costs, and support organizational growth.
The summary above was generated by AI
CompanyNavitus About UsNavitus - 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 RangeUSD $152,077.00 - USD $190,096.25 /Yr. STAR Bonus % (At Risk Maximum)15.00 - Director, GM of GP, PIC Work Schedule Description (e.g. M-F 8am to 5pm)M-F 8am to 5pm Remote Work NotificationATTENTION: 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

Due to growth, we are adding a Director, Clinical Strategy (RPh) to our team.


The Director, Clinical Strategy (RPh) is a clinical and strategic leader responsible for owning formulary strategy and clinical business development across the organization. This role translates clinical evidence, market dynamics, and client needs into actionable formulary and clinical strategies that drive improved patient outcomes, cost management, and competitive differentiation. This leader provides direction on drug information and clinical management, formulary and utilization management strategy, and clinical business development to ensure alignment from strategy through execution.


Is this you? Find out more below!  

Responsibilities

How do I make an impact on my team? 

  • Design, structure, and develop long-term evolution of enterprise formulary and utilization management strategy.
  • Accountable for the fiscal management of the department, including forecasting, budget development, ongoing variance monitoring, and trending.
  • Serve as the authority on formulary strategy decisions, incorporating clinical evidence, market dynamics, and financial considerations.
  • Provide clinical leadership in governance forums, including Pharmacy & Therapeutics (P&T), Formulary Advisory (FAC), Medically Administered Products Committees, and other committees as delegated.
  • Develop and lead clinical and formulary strategies aligned to organizational growth, client needs, and industry trends.
  • Monitor emerging drug pipeline and therapeutic trends to proactively shape formulary positioning and strategy.
  • Lead clinical strategy input for new business pursuits and client retention efforts.
  • Foster cross-functional and inter-professional work teams to drive results in support of the strategic plan of the organization.
  • Ensure formulary and clinical strategies align with regulatory requirements, accreditation standards, and internal policies.
  • Design and oversee clinical criteria for prior authorizations, step therapy, and quantity limits to ensure appropriate medication use.
  • Maintain accountability for clinical integrity and appropriateness of decision-making.
  • Provide leadership, training, and supervision to team members to ensure consistent and maximum performance levels.
  • Other duties as assigned.
Qualifications

What our team expects from you?

  • Bachelor’s degree in pharmacy or PharmD degree required. 
  • 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.
  • 8+ years of experience in PBM, managed care, or clinical pharmacy leadership required.
  • 5+ years of experience leading multiple teams or functions with both clinical and business impact 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
  • Educational Assistance Plan and Professional Membership assistance
  • Referral Bonus Program – up to $750!

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