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Director, Health Plan Strategy - Remote

Navitus Health Solutions LLC
Phoenix, AZ
  • Posted: over a month ago
  • Full-Time
Job Description

Pharmacy Benefits Reinvented- As the industry’s alternative pharmacy benefit manager (PBM), we’re committed to making prescriptions more affordable for you and your members. Here at Navitus, our team members work in an environment that celebrates creativity, fosters diversity.

The Director, Health Plan Strategy (Director) will be responsible for the implementation and ongoing support of the Health Plan strategy. The strategy consists of a portfolio of initiatives enabling the development, sales, client management and execution of the Health Plan program and products. The Director provides expert support for all aspects of the Health Plan program strategy and operations. The Director assesses the Health Plan program capacity and capabilities for managing new clients, directs and manages the implementation of the new Health Plan program and oversees subject matter expert (SME) support. The Director is responsible for staying abreast of and understanding industry, marketplace, and partnering with Legal Affairs and Government Programs on regulatory and legal developments, their impact on the business and translating current and emerging market needs into product expansion/enhancement or new product concepts/business cases.

The Director will work with all key functional areas to ensure high quality product development and on-going support of the Sales and Client Services departments. In addition, the Director will support the Chief Growth Officer for socializing the Health Plan strategy throughout Navitus’s leadership. The Director will assist with sales forecasting, sales RFPs and finalist presentations; and will provide competitive insights regarding market pricing and customer requirements and/or feedback.

This role requires strong technical writing skills, deep knowledge of Health Plan PBM needs and a deep knowledge of both the technical and marketing sides of the Health Plan products. Is this you? Find out more below!

How do I make an impact on my team?

  • Provide direction on product development for Health Plan products and makes recommendations regarding the operating model to support dynamic Health Plan clients.
  • Ensure individual project managers assigned to Health Plan products, projects, and solutions are supported and have the resourcing support needed to succeed. The Director is the primary point of contact to resolve project/product resource constraint and major Health Plan program issues.
  • Work with Client Services, Clinical Client Services, and Government Programs to assess the Health Plan program capacity and capabilities for managing new and existing clients and enabling the Health Plan sales strategy.
  • Coordinate functions and communications throughout the organization as a “hub” to ensure the successful delivery of the strategy for Health Plan clients.
  • Stay abreast of and understand industry, marketplace, and legal developments and their impact on the business. Translate current and emerging market needs into product expansion/enhancement or new product concepts/business cases.
  • Assist Navitus in attaining and maintaining a deep understanding of Health Plan sales channel.
  • Oversee the implementation of new Health Plan program requirements and ensure successful ongoing operational administration. Requires strong collaboration and partnership with operational leaders throughout the life of the program development and implementation.
  • Develop Health Plan program performance goals including membership, data and processing quality, profitability, and compliance and oversees program monitoring and reporting.
  • Ensure new Health Plan program and products meet all regulatory requirements.
  • Support Sales and Client Services with expertise, training and sales tools, as well as assistance in establishing Health Plan partnerships, providing RFP responses, and attending finalist presentations.
  • Provide direction and oversight for the development, modification and improvement of business processes and policies associated with new products/services.
  • Develop and continually improve strategies, objectives and policies for the Health Plan program. Oversee the project intake process for evolving Health Plan needs to ensure projects are ready for resource allocations. This includes determining the optimal mix for project delivery and schedule of projects/programs.
  • Develop strong relationships with key internal and external stakeholders and decision makers.
  • Active participant in the Health Plan Strategic Taskforce. Provide status updates to the taskforce that include progress towards established goals, risk mitigation plans, and other key pieces of information to accurately reflect the health of the Health Plan program.
  • Partner with Marketing and Communications on the development and implementation of enterprise-wide strategic communication plan.
  • Accountable for managing the Health Plan program budget.
  • Participate in, adhere to, and support compliance program objectives.

What our team expects from you?

  • A minimum of a bachelor’s degree in Business, Health Care Administration, or closely related field.
  • Six to eight years of experience in administering health insurance programs and/or product management.
  • A Master’s degree is strongly desirable.
  • Experience and expertise in new product development, product management, marketing, and sales and/or strategic planning with a “track record” of tangible success, including leadership and team collaboration/relationship-building/management in a health care or related environment is essential.
  • Direct extensive knowledge and experience with Health Plans.
  • Medicare, Medicaid and/or ACA Marketplace experience 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?

  • Hours/Location: Monday – Friday: Remote
  • Paid Volunteer Hours
  • Educational Assistance Plan and Professional Membership assistance
  • Referral Bonus Program – up to $750!
  • Top of the industry benefits for Health, Dental, and Vision insurance, Flexible Spending Account, Paid Time Off, Eight paid holidays, 401K, Short-term and Long-term disability, College Savings Plan, Paid Parental Leave, Adoption Assistance Program, and Employee Assistance Program

Navitus Health Solutions LLC


Phoenix, AZ
85054 USA



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