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Associate Manager, Clinical Informatics

Navitus Health Solutions, LLC Madison Full-Time
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The Associate Manager, Clinical Informatics will work closely with our account management and clinical account management teams, to support the needs of our clients. They will use logic and analytic skills to manage client analyses in response to specific business questions and be able to communicate the findings, including methodology and estimated outcomes. This person will be responsible for analysis of claims utilization data for the benefit of Navitus' clients and its membership. The individual will be expected to manage, understand and interpret data, including claims utilization from Navitus' data warehouse and from NCRx (Navitus' claims adjudication system), formulary files, pharmacy network databases, Medispan files, and other databases required from time-to-time to facilitate successful delivery of information for decision-making. Analyst duties will emphasize data analysis and forecasting impact of Plan design, formulary, P&T and other changes that will lead to an enhanced value proposition to current and prospective clients and support with pharmacy-medical data integration. The individual in this position will demonstrate competence in the use of multiple informatics tools including MS Office products and Qlikview. SAS, SQL and Visual Basic development are a plus but not required. The Associate Manager, Clinical Informatics will work closely with individuals from various functional areas such as Analytics, Health Strategies, Provider services, Client services and Lumicera.

Essential Job Duties:

  • Manage and evaluate the financial and member impact of benefit design changes and formulary modifications
  • Empower employees to take responsibility for their jobs and goals. Delegate responsibility and expect accountability and regular feedback evaluation
  • Manage, benchmark, report, and analyze pharmacy costs including clinical programs changes to drug costs, rebates and net drug spend
  • Support all clients by providing solutions based on client-specific data reports and comparisons to benchmarks through innovative tool development and trending mechanisms
  • Identify and present financial savings opportunities for clients through detailed analysis of inappropriate drug use, misuse, persistency, adherence, and formulary changes
  • Manage client ad hoc reporting including the development and maintenance of clinical client reports that contain insightful, action-oriented information
  • Manage and provide valuable consultation and expertise in program outcomes reporting and analysis tools
  • Create models that display meaningful client, and/or clinical information in easy to understand presentations. Participate in clinical and client meetings to gather business use cases to develop new models and analyses
  • Anticipate, design, and measure solutions to facilitate the business and clinical needs of the organization including qualitative and quantitative reporting and analysis
  • Support of prospective client reporting and analytics including plan design analysis, formulary analysis, generic utilization forecasting, clinical program savings evaluation
  • Ability to work independently in a fast-paced environment and manage tight deadlines. Effectively leverage team resources to support client business needs
  • Able to communicate complex findings to Director and VP level
  • Provide insight and information using industry and technical knowledge to elicit client retention and engagement
  • Communicate reporting results, financial values, and outcomes to internal and external clients as needed
  • Creative thinking to develop leading solutions to respond to changing healthcare landscape from a technology angle
  • Train the Account team, Clinical team and Clients in using the Navigate 3D reporting tools
  • Support with pharmacy-medical data integration
Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled

Education:

BA/BS required. Educational concentration consisting of information systems, statistics, or business preferred. Additional courses in a health related field, especially pharmacy, desirable. An advanced degree in pharmaco-economics is especially desirable.

Experience:

2 to 3 years experience in healthcare economics or financial modeling and analysis. Knowledge of health care processes or pharmaceutical claims adjudication systems. Experience with Microsoft Excel and Access, and SQL or equivalent programming is preferred Ability to analyze and interpret data and exercise appropriate judgment is required. Applicant must be proficient in relational databases and statistical applications. Excellent oral and written communications is required. Ability to plan, organize and focus on outcomes is critical. Ability to professionally interact at all levels of organizations (both internal and external) is required.

#LI-POST

Skills required

Data Analysis
Analysis
Data Management
Documentation
Economics
Business Requirements
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Transparency. Stewardship. Performance.

These aren’t just words or tired philosophies at Navitus Health Solutions; they are the ideals that form the cornerstone of our company. Each word defines how we operate, communicate, and how a Pharmacy Benefit Manager fully committed to aligned results can make a difference to your organization’s bottom line.

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