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._____________________________________________________________________________________________________________________________________________________________________________________________________________. Current associates must use SSO login option at https://employees-navitus.icims.com/ to be considered for internal opportunities.

USD $26.51 - USD $31.95 /Hr.

M-F 8am to 4:30pm

ATTENTION: Navitus is unable to offer remote work to residents of Alaska, Hawaii, Maine, Mississippi, New Hampshire, New Mexico, Rhode Island, South Carolina, South Dakota, West Virginia, and Wyoming.

Due to growth, we are adding an Accumulator Analyst to our CAO Client department.  

 

The Accumulator Analyst ensures efforts are in alignment with the Claim Adjudication Operations (CAO) team to leverage technology and process improvement for the purpose of meeting the business needs of Navitus customers, clients, members, and pharmacies by accurately administering benefits. This role is responsible for the ongoing management of client accumulator processes and will function as the lead accumulator resource for assigned clients, as well as a back-up resource for peer coordinators when needed. This position requires knowledge of both the technical and operational sides of the business. The Accumulator Analyst will work closely with Information Technology, Benefit Configuration, Eligibility and Client Services teams to understand the interdependences of each functional area.

 

This position may include after-hour and/or weekend hours depending on workload.

 

Is this you? Find out more below!

How do I make an impact on my team? 

• Oversees, manages and maintains accumulator data, processes and services for strategic and complex clients. This includes understanding client needs, plan designs, monitoring of electronic file loads and subsequent reports and any additional accumulator related processes
• Performs accumulator updates timely and accurately to prevent member access to care issues, missed performance guarantees and potential liquidated damages
• Works directly with client contacts and supports internal customers by participating in client meetings, audits and new program implementations with other areas of the company, answering accumulator questions and providing guidance to other areas and roles on accumulator processes
• Requests, validates and confirms full file data feeds from clients to ensure system integrity through audits and reconciliation
• Collaborates directly with client and/or Client Services team to report data file errors, accumulator reconciliation results and performance guarantee metrics on an agreed upon client schedule
• Researches root cause of issues, troubleshoots viable resolutions and makes recommendations for corrective action
• Educates others on the accumulator process, providing talking points for Member Services to explain accumulator to members and pharmacies, to Client Services and Government Programs to explain corrective outcomes and to Sales Support for proposal responses
• Conducts system enhancement and regression testing for highly complex accumulator related processes to ensure compliance with state, federal and client regulations/standards
• Contributes to training and maintains a mentoring relationship with new and existing accumulator team members. Assists in the creation and ongoing maintenance of departmental training materials, work instructions and policies
• Other duties as assigned

What our team expects from you?

• Associate degree or equivalent work experience
• Minimum of two (2) years of experience as an Accumulator Coordinator II
• Experience with the following tools at an intermediate to advanced level: Navi-ClaimRx, Microsoft Office (Word, Excel, Dynamics (CRM)), Text Editing (e.g., Notepad++/UltraEdit), Request Management (Service Desk, Connectus, Responsive), Reporting (3D QlikView/QlikSense), and FTP File Transfer/Retrieval (FileZilla)
• 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 
• Educational Assistance Plan and Professional Membership assistance 
• Referral Bonus Program – up to $750! 

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