Navitus Health Solutions

We are committed to helping humans by making medications more affordable for the people who need them.

Principal, PBM Business and Regulatory Strategy

ComplianceComplianceFull TimeRemoteTeam 1,001-5,000Since 2003H1B No SponsorCompany SiteLinkedIn

Location

Idaho

Posted

5 days ago

Salary

$129.0K - $161.2K / year

Bachelor Degree10 yrs expEnglish

Job Description

• Drive cross‑functional 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 fit‑for‑purpose evidence models (reports, dashboards, logs, audit trails) and/or testing protocols to demonstrate ongoing adherence to regulatory requirements. • Ensure policies, procedures, desk‑level 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. • Sign‑off authority on control adequacy and evidence sufficiency for go‑live operational readiness. • Monitor reduction in post‑go‑live defects and implement root cause analysis or defect remediation plans supportive of the regulatory environment. • Other duties as assigned.

Job Requirements

  • 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 cross‑functional 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 front‑line 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 objectives
  • The ability to consistently interact cooperatively and respectfully with other employees.

Benefits

  • Top of the industry benefits for Health, Dental, and Vision insurance
  • 20 days paid time off
  • 4 weeks paid parental leave
  • 9 paid holidays
  • 401K company match of up to 5% - No vesting requirement
  • Adoption Assistance Program
  • Flexible Spending Account
  • Educational Assistance Plan and Professional Membership assistance
  • Referral Bonus Program – up to $750!

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