
1001 - 5000 employees
Founded 2003
⚕️ Healthcare Insurance
💊 Pharmaceuticals
🤝 B2B
Healthcare Insurance • Pharmaceuticals • B2B
Navitus Health Solutions is a pharmacy benefit manager (PBM) that provides transparent, people-centered pharmacy benefit solutions to health plans, employers, government programs and other plan sponsors. The company operates a 100% pass-through, cost-plus model that emphasizes lowering medication costs, managing formularies, specialty drug management (including a cost-plus specialty pharmacy), claims adjudication, pharmacy network management, and member enablement and support services. Navitus positions itself as a fiduciary partner focused on affordability, compliance, clinical quality and improving health outcomes through tailored PBM services and digital health integrations.
🕒 6 days ago
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1001 - 5000 employees
Founded 2003
⚕️ Healthcare Insurance
💊 Pharmaceuticals
🤝 B2B
Healthcare Insurance • Pharmaceuticals • B2B
Navitus Health Solutions is a pharmacy benefit manager (PBM) that provides transparent, people-centered pharmacy benefit solutions to health plans, employers, government programs and other plan sponsors. The company operates a 100% pass-through, cost-plus model that emphasizes lowering medication costs, managing formularies, specialty drug management (including a cost-plus specialty pharmacy), claims adjudication, pharmacy network management, and member enablement and support services. Navitus positions itself as a fiduciary partner focused on affordability, compliance, clinical quality and improving health outcomes through tailored PBM services and digital health integrations.
• Prepare monthly finance accrual recommendations for review by Sr. Manager and support leaders as needed for monthly accrual meeting with Finance • Responsible for maintaining and designing team SharePoint site and identifying opportunities for enhancements based on trending of team productivity and accomplishments to help ensure successful completion of team’s work and meeting Navitus’ strategic and business initiatives • Accountable for data quality, completeness and accuracy in team workflow tools, including RFP/renewal deadlines and new client implementations • Accountable for maintenance of frequently used resource documents on team SharePoint site, including performance guarantee library, FAQs, subject matter experts and standard performance guarantee contract exhibit • Guide existing and train new contract performance analysts as well as inspire positive communication within the entire contract performance team to work together to achieve common goals • Assist Contract Performance team with the Request for Proposal (RFP) process process which includes but is not limited to the following: Review RFP requested performance guarantees • Compare to previously requested guarantees for consistency • Present findings to Contract Performance team • Perform outreach for departmental approval of performance guarantees • Consolidate responses and review with Contract Performance team • Deliver RFP response to Proposal team • Upon Client win notification, review service, network and/or rebate guarantees agreed to during the RFP process and notify operational areas • During contract negotiations, analyze contract redlines, perform outreach for departmental approval of any performance guarantee edits and prepare final recommendations • Upon contract execution notification, communicate final contract guarantees to operational areas prior to go-live • Responsible for Performance Guarantee (PG) reporting which includes but is not limited to the following: Monitor the collection of monthly, quarterly and annual service performance guarantee results from process owners • Identify, research and facilitate corrective action for missed guarantees with the process owners and Client Services team and determine penalty payout when applicable • Analyze underperformance in network financial performance reports and notify Pharmacy Networks team to solicit cause and next steps if needed • Assists the Manager with the development, documentation, implementation, and maintenance of performance guarantee data repositories and report writing programs • Prepare PG-related reporting for senior leadership as needed • Schedule, facilitate and document meetings and discussions • Participate as a member of cross functional workgroups, teams, and committees, as assigned • Assist with the creation and maintenance of departmental work instructions • Other duties as assigned
• College degree or equivalent experience required in the field of business administration, contract management, health care administration or related field and/or a minimum of 4 years of relevant professional experience • Hands-on experience handling multiple projects simultaneously • Ability to manage requirements, maintain deadlines on deliverables, and communicate on an ongoing basis with business partners and internal clients about contract performance issues • Ability to systematically analyze complex problems, draw relevant conclusions and implement appropriate solutions • Participate in, adhere to, and support compliance program objectives • The ability to consistently interact cooperatively and respectfully with other employees.
• 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!
Apply Now🕒 6 days ago
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