New 
Manager, Government Clinical Services
 Navitus Health Solutions | |||||||
$120,000.00 - $150,000.00 /Yr.
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vision insurance, flexible benefit account, parental leave, paid time off, paid holidays, 401(k), remote work
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 United States, Wisconsin, Madison | |||||||
 Nov 04, 2025 | |||||||
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Manager, Government Clinical Services Location
US-WI-Madison ID
2025-5224
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._____________________________________________________________________________________________________________________________________________________________________________________________________________. Current associates must use SSO login option at https://employees-navitus.icims.com/ to be considered for internal opportunities. Pay Range USD $120,000.00 - USD $150,000.00 /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, North Dakota, Rhode Island, South Carolina, South Dakota, West Virginia, and Wyoming. Overview Navitus Health Solutions is seeking a Manager, Government Clinical Services to join our team!
The Manager, Government Clinical Services provides strategic vision and operational oversight of the department as well as direct management and leadership of clinical staff within the department. The Manager ensures prompt program execution, presents products to external and internal clients, and drives results in support of the corporate strategic plan. The Manager will have responsibility for the required clinical services and for driving outcome analysis initiatives to completion. The Manager, in coordination with the Program Manager of Government Clinical Services, oversees duties related to the development, implementation, outcomes reporting, and ongoing administration of Navitus' clinical programs, reports, and edits for Medicare and Medicaid populations while fostering a collaborative and cohesive team culture.
Is this you? Find out more below! Responsibilities How do I make an impact on my team? * Provide leadership, training, supervision, and strategic direction to department Pharmacists and Product Managers.
* Assist with the fiscal management of the department, including forecasting, budget development, staffing, and trending of programs, in support of Navitus' strategic and business initiatives.
* Lead the development of new clinical programs and manage the maintenance and continuous improvement of existing programs to keep innovation and evidence-based programs a differentiator for Navitus.
* Serve as a key stakeholder and decision-maker on implementation of new Medicaid and Medicare clinical requirements.
* Have strong knowledge of current standards, regulations, and guidance including CMS, PQA, and HEDIS measures and have the ability to concisely communicate that information to stakeholders and clients.
* Assist Customer Care, Customer Success, and other internal customers in responding to and resolving pharmacy-related inquiries from Medicaid and Medicare members, clients, providers, or pharmacies.
* Assist the Residency Program Director with the accredited PGY1 Managed Care Residency Program.
* Assist the Customer Success, Implementation, and Government Programs teams with new Medicaid and Medicare implementations and with annual re-implementations, including support of the transition process to ensure clinical and operational functionality.
* Other duties as assigned
Qualifications What our team expects from you? * Bachelor's degree in pharmacy or Pharm D required.
* 5 years clinical experience, or clinical/managed care pharmacy practice residency plus three years clinical experience required.
* Knowledge of PBM industry, formulary management, clinical outcomes research, pharmacy claims, and managed care principles and practices desired.
* 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
Location : Address 361 Integrity Drive Location : City Madison Location : State/Province WI Location : Postal Code 53717 Location : Country US | |||||||