Principal, PBM Business and Regulatory Strategy
Principal, PBM Business and Regulatory StrategyLocationUS-ID2026-5630CategoryGrowthPosition TypeFull-TimeRemoteYesCompanyNavitusAbout 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 $132,000.00 - USD $166,000.00 /Yr.STAR Bonus % (At Risk Maximum)5.00 - Salaried Non-Management except pharmacistsWork Schedule Description (e.g. M-F 8am to 5pm)M-F 8am - 5pmRemote 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.OverviewDue to growth, we are adding headcount! Our Principal, Business and Regulatory Strategy will be the liaison between legal and our provider services team using superior knowledge of PBM regulatory requirements to align them with our payables and reimbursement strategies.The Principal, Business and Regulatory Strategy is for driving business solutions and readiness that aligns with regulatory transformation and requirements. Acting as a connective tissue between Compliance, Legal, Product, Technology, Operations, and the business unit, this role translates the interpretation of statutes from the Legal team including rules, guidance, and standards into actionable work, and facilitates durable, riskright solutions. The role partners closely with Legal on interpretation, drives crossfunctional implementation plans, designs and validates controls, and ensures sustainable adherence for Medicare, Medicaid/State programs, Exchange/Commercial, privacy & security, auditing/monitoring, and related accreditation obligations.Is this you? Find out more below! ResponsibilitiesHow do I make an impact on my team?Drive crossfunctional operational requirements and implementation (scope, milestones, owners, dependencies, and success criteria) spanning Product, Operations, Technology, and Customer Success.Coordinating complex pharmacy benefits relationships through operational and contract understanding, inter-entity dynamics, and reimbursement structures and strategies.Facilitate solution design to reflect regulatory intent and operational practicality.Manage traceability from requirement to control to process/tech change to evidence.Define/validate preventive & detective controls; align with policies, standards, and procedures.Establish accompanying fitforpurpose evidence models (reports, dashboards, logs, audit trails) and/or testing protocols to demonstrate ongoing adherence to regulatory requirements.Ensure policies, procedures, desklevel work instructions, and training are updated prior to effective dates.Coordinate change readiness and adoption with affected teams including recommending content relevant to client impact and experience.Exercise authority to gate/hold releases when regulatory or control gaps create material risk, escalating through leadership as needed.Signoff authority on control adequacy and evidence sufficiency for golive operational readiness.Monitor reduction in postgolive defects and implement root cause analysis or defect remediation plans supportive of the regulatory environment.Other duties as assigned.QualificationsWhat our team expects from you?Bachelor's degree in business, or other directly applicable field, or equivalent work experience, required.10+ years' experience in healthcare/health plan/PBM regulatory compliance, pharmacy operations management, regulatory operations, or operational implementation required.Demonstrated success leading crossfunctional regulatory change.Ability to translate regulatory text into practical requirements, contractual implications and control designs; strong partnership with Legal and technical/operational teams.Proficiency with risks, issues, testing, and evidence advanced communication, facilitation, and influence skills across executive to frontline levels.Strong knowledge of pharmacy contracting and/or pharmacy benefits regulatory requirements.Proven ability to lead cross-functional teams and influence senior stakeholders. Participate in, adhere to, and support compliance program objectivesThe ability to consistently interact cooperatively and respectfully with other employeesWhat can you expect from Navitus?Top of the industry benefits for Health, Dental, and Vision insurance20 days paid time off4 weeks paid parental leave9 paid holidays401K company match of up to 5% - No vesting requirementAdoption Assistance ProgramFlexible Spending AccountEducational Assistance Plan and Professional Membership assistanceReferral Bonus Program - up to $750!#LI-Remote Location : AddressRemoteLocation : Country