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 $55,151.00 - USD $66,447.00 /Yr.

M-F 8am-5pm, CST

Navitus Health Solutions is seeking an Analyst, PA Accel  to join our Prior Authorization department! 

 

The Analyst, PA Accel is to be a subject matter expert for configuration of the automated Prior Authorization (PA) tool, in addition to reporting on automated PA related information. The Analyst will work in tandem with Product Manager, Supervisor, and Manager to ensure accurate configuration, understand Navitus’ current state, and improve this product for internal and external benefit.  

 

Is this you? Find out more below!  

How do I make an impact on my team?   

• Prepare analyses and work orders for pharmacy drug prior authorization criteria sets, which can be configured in our automated prior authorization system.  
• Completes scheduled and urgent Prior Authorization criteria additions, terminations, and changes timely and accurately to prevent member access to care issues, missed performance guarantees and potential liquidated damages. 
• Performs quality assurance peer reviews and uses sound business judgment and expertise to contribute toward the creation of root cause analysis of issues.  
• Conducts system enhancement and regression testing of a low to moderate level of complexity for benefit configuration processes to ensure compliance with state, federal and client regulations/standards. 
• Analyze and report on program specific data associated with PA Accel. 
• Ensure automated prior authorization continues to function as intended and is scalable to Navitus’ clients.  
• Coordinate enhancement efforts with Product Manager, and aid in user tests as they are implemented. 
• Onboard new and existing clients onto the automated PA platform. 
• Complies with standards set forth regarding automated Prior Authorization benefit design and configuration including HIPAA, NCPDP and Navitus internal business standards. 
• Be an internal point of contact on this product and work with cross-functional teams to audit, implement, enhance, train, and explain the benefits of the product.  
• Other duties as assigned 

What our team expects from you?  

• A minimum of a Bachelor's Degree in a science, business, or mathematics related field, or at least four years of equivalent work experience is required.   
• Experience with Prior Authorization and/or reporting and a “track record” of tangible success, and team collaboration/relationship-building/management is essential. 
• Must be able to exercise appropriate judgment. 
• Intermediate experience with Excel required. 
• Experience with pharmacy prior authorization or PBM knowledge preferred.  
• Participate in, adhere to, and support compliance program objectives 
• The ability to consistently interact cooperatively and respectfully with other employees 

 

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.