Navitus

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.

USD $77,545.00 - USD $95,148.00 /Yr.

M-F 8am-5pm, CST

Due to growth, we are adding an Regulatory Adherence and Audit Manager to our compliance department.

 

This position is responsible for company-wide internal audits in accordance with annual audit objectives and work plans, established audits, and state and federal regulations implemented by Navitus’ Legal team.   This also includes responding to external audit activities and facilitating enhancements to established audits. The Manager will be responsible for prioritizing and coordinating all audit activities, conducting quality assurance review on all audit responses, and facilitate process improvement initiatives necessary to support ever changing regulations and/or contract requirements. The Manager acts as the liaison with functional areas as it relates to discovery, evidence gathering, and testing in those areas.  The Manager ensures that the appropriate processes, procedures, and software are implemented to meet audit requirements. This role requires project management skills, strong Excel and other technical writing skills and deep knowledge of healthcare compliance and regulation.

 

Is this you? Find out more below!

How do I make an impact on my team? 

• Facilitates and/or leads all audit activities, including educating staff on audit requirements; coaching or otherwise assisting in interview preparations, when applicable, providing oversight to the processes that extract data needed for audits; and coordinates all audit activities
• Assist internal business units in interpreting audit findings, preparing and completing audit responses, developing corrective actions as appropriate, and monitoring to ensure that corrective actions are successfully implemented
• Develops, implements, and maintains an audit tracking and documentation system
• Conducts annual risk assessment activities, including interviews, ranking, reporting, and review with the Compliance Committee. Integrates risk assessment results into the annual audit plan
• Leads multiple teams of auditors for regulatory, compliance, policy, and other auditing and monitoring
• Reporting on control deficiencies to management and making recommendations to mitigate risk and add value
• Performs quality assurance on business processes to ensure accuracy and compliance with state and federal regulations, State, and client requirements
• Assists in audit/compliance awareness, training, and education initiatives by contributing to the Compliance newsletter and educational activities
• Oversees all non-compliance related activities including scope, impact assessments, process improvement projects, and client notifications
• Collaborate as needed with Government Programs team on Medicare, Medicaid, and Exchange services where there is overlap or dual impact across those program regulations
• Other duties as assigned

What our team expects from you?

• Bachelor's Degree in related discipline or equivalent relevant work experience
• 5+ years’ experience and expertise in audits, healthcare claims operations, regulatory analysis, facilitating process improvement, reporting, and/or project management, with a “track record” of tangible success, including team collaboration/relationship-building or management in a health care or related environment is essential
• Experience and expertise in healthcare regulations and compliance highly 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
• 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

#LI-Remote

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.