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 $93,671.00 - USD $114,934.00 /Yr.

M-F 8am-5pm, CST

Due to growth, we are adding Manager, Medicare Finance Operations to our Government Programs department. 

 

As part of the Government Programs Team and reporting to the General Manger, Medicare Part D, the Manager, Medicare Finance Operations s administer all Medicare Finance operational responsibilities on behalf of Navitus’ Medicare Product and those operational responsibilities delegated to Navitus by our Medicare Part D health plan clients. The Manager will define new operational processes, including the new Medicare Prescription Payment Plan (M3P), leading the Medicare Finance team, and serving in a backup role whenever necessary for all Medicare Finance team functions This position will interface primarily with the Navitus Corporate Finance Team, Actuarial Team, Underwriting Team, Government Programs Technical Operations, and Client Account Management.

 

Is this you? Find out more below!  

How do I make an impact on my team?   

• Defines operational processes and determines ongoing support needs for new operational processes including the new Medicare Prescription Payment Plan (M3P). Completes overall reconciliation of M3P financial processes for Navitus EGWP clients, including collaboration with Navitus Finance on integration with corporate billing system and general ledger.
• Manages a matrix of operational processes to assigned resources. Ensures detailed work instructions are developed and maintained. Manages workload of team members and continually balances priorities with available resources.
• Oversees Medicare Part D Payment processing, DIR, MLR, M3P, Medicare Part D benefit administration, and related financial functions
• Oversees reconciliation of monthly, quarterly, and annual (including plan year re-openings) CMS and drug manufacturer reimbursements to the employer group and manages the group level reporting and payments. Manages reporting to CMS as well as dispute processes.
• Oversees monthly Plan to Plan (P2P) payment processes, Low Income Premium Subsidy (LIPS) payments, and CMS Late Enrollment Penalty (LEP) billing & collection processes.
• Monitors client performance related to CMS subsidies. Collaborates with Navitus Actuarial Services team on CMS subsidies forecasts. Completes ad hoc analyses per Client requests.
• Serves as a CMS Star Ratings subject matter expert (SME). Oversees CMS Star Ratings and Display Measure tracking and reporting capability for all Navitus Part D clients. Participates in the Star Ratings Center of Excellence (COE) team and provides RFP support related to Star Ratings.
• Other duties as assigned

What our team expects from you?  

• A minimum of a bachelor’s degree in Finance or Accounting is required.
• 5+ years of experience in a Financial Analyst role with relevant financial operations management experience in a Medicare health plan or PBM.
• 2+ years of direct supervisory responsibilities including experience making hiring decisions, writing performance reviews, and providing performance coaching.
• Experience in interpreting and articulating regulatory requirements.
• Experience with interfacing with external clients.
• Project management experience
• 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.