Manager, Health System Pharmacy Revenue Integrity

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. ._____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________. 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 Range USD $112,640.00 - USD $140,799.00 /Yr. STAR Bonus % (At Risk Maximum) 10.00 - Manager, Clinical Mgr, Pharm Supvr, CAE, Sr CAE I Work Schedule Description (e.g. M-F 8am To 5pm) M-F, 8am-7pm CT Remote Work Notification ATTENTION: Lumicera is unable to offer remote work to residents of Alaska, Connecticut, Delaware, Hawaii, Kansas, Kentucky, Maine, Massachusetts, Mississippi, Montana, Nebraska, New Hampshire, New Mexico, North Dakota,Rhode Island, South Carolina, South Dakota, Vermont, West Virginia, and Wyoming.

Overview

The Manager, Health System Pharmacy Revenue Integrity, is responsible for optimizing health system pharmacy strategies and programs to ensure financial resilience and success for partners of Lumicera Health System Solutions and Navitus Clients. The Manager and their team will work cross-functionally with teams at Lumicera and Lumicera-operated pharmacies to deliver value for partners through designing, implementing, and continually improving workflows and processes that achieve revenue and operating margin goals. In addition, this associate will provide subject matter expertise and guidance for Navitus and Navitus’ Clients seeking strategic guidance on health system revenue optimization. Achieving success in this position will be reflected by growing and maintaining revenue flow through health system pharmacy partners. Deploying strategies in drug purchasing, payor contracting, and site of care medication administration will be key areas of focus. Expertise in guiding compliant optimization of savings available through government programs including the 340B program and the Inflation Reduction Act Medicare Maximum Fair Price drug rebates to our partner organizations is also paramount. The ability to adapt to changes in the rapidly changing health system landscape will be key to delivering results expected. The ultimate goal will be to position Lumicera Health System Partners and Navitus Clients to sustain financial success through their pharmacy revenue strategy across the health system pharmacy program continuum.

Responsibilities

How do I make an impact on my team?

• Develop and maintain subject matter expertise in operational tools and software applications including, but not limited to, RxVector/Agile Care, NCRX, Lighthouse, CoverMyMeds, Lumicera Digital Engagement Programs for Patients and Providers, Manufacturer Patient Assistance Programs, Manufacturer Enhanced Services Programs, Phone System(s), CRM, Alvaria, Jira, and Electronic Medical Record navigation, communication, and documentation.
• Partner with Health System pharmacy, finance, and revenue cycle leaders to ensure aligned charging, billing, and reimbursement workflows.
• Provide financial impact analysis for new specialty therapies, biosimilars, site-of-care shifts, and program expansions.
• Proactively communicate opportunities and risks for 340B program qualifications to Lumicera and Navitus partner organization leadership based on current and future changes to the 340B Program landscape.
• Develop reporting and presentation on the current performance and additional opportunity analysis for Lumicera and Navitus partner organizations participating in the 340B program.
• Support appeals strategies and remediation plans for recurring pharmacy reimbursement issues.
• Effectively utilize analytics to track and trend successes and opportunities both internally at Lumicera, as well as externally with partners. Dev

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