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

M-F 8am to 5pm CT

ATTENTION: Navitus is 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.

Due to growth, we are adding a Manager, Issue Management to our CAO Quality department.  

 

The Manager, Issue Management is responsible for revamping and overseeing issue management processes, leading a team of direct reports, and maintaining effective communication with internal and external partners. This role serves in a strategic capacity to manage claims reprocessing initiatives, mitigate organizational risk, and ensure comprehensive documentation of business requirements. The ideal candidate will have strong leadership skills, experience in issue management, root cause analysis, preventative action planning, process improvements, and excellent client-facing abilities. 

 

Is this you? Find out more below!  

How do I make an impact on my team?   

• Lead, mentor, develop, and manage a team of direct reports 
• Provide guidance and support to team members to ensure high performance and professional growth 
• Conduct regular team meetings and performance reviews 
• Revamp current issue management process with insight from key stakeholders 
• Oversee the identification, tracking, and resolution of issues within PBM operations 
• Maintain detailed records of issues, root cause analyses, and preventative actions 
• Communicate findings and action plans clearly to client facing teams 
• Build and maintain strong relationships with clients/client facing teams and address their concerns effectively 
• Conduct and oversee root cause analyses (RCA) to identify underlying issues 
• Develop and implement preventative action plans to mitigate future issues 
• Advise and provide support to team members on RCA and preventative action methodologies 
• Apply knowledge of claims processing workflows, systems, and procedures, including adjudication, resolution, and documentation standards, to support team operations and ensure accuracy and compliance 
• Other duties as assigned 

What our team expects from you?  

• Bachelor’s degree or equivalent work experience is required 
• 5+ years of experience required in issue management, root cause analysis, and preventative action planning within the PBM or healthcare industry 
• Proven experience in leadership and team management is required 
• Demonstrated knowledge of claims processing workflows, systems, and procedures, including adjudication, resolution, and documentation standards is required 
• Experience with root cause analysis tools and methodologies 
• Proficiency in Microsoft Office Suite 
• Knowledge of regulatory requirements and industry standards in PBM 
• 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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US