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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.
Due to growth, we are adding Director, Claims Quality Assurance & Testing to our Customer Operations department.
We are 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.
The Director, Claims Quality Assurance & Testing is responsible for the overall testing strategy and execution spanning all new PBM client implementations and existing PBM client configuration changes. The role has direct ownership and accountability for testing and testing teams spanning all aspects of pharmacy benefit client deliverables. This includes pre-adjudication inputs such as hierarchy, eligibility, plan benefits, formulary, utilization management, networks, historical claims and historical MPA data, as applicable. In addition, it includes post-adjudication elements Such as claims extracts, EOBs, member portal views, API integrations and Prescription Drug Events. Success in this role will require collaboration across the enterprise to ensure accurate and timely information and data flow to meet client requirements.
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#LI-Remote
Full Time
Ancillary Healthcare
$160k-198k (estimate)
01/19/2024
05/08/2024
navitus.com
APPLETON, WI
200 - 500
2003
Private
ALLEN ZIMMERMAN
$200M - $500M
Ancillary Healthcare
Navitus is a provider of pharmacy benefit management services for employers, unions and individuals.