Vendor Manager, Client Operations

🕒 6 days ago

🥔 Idaho – Remote

🥔 Idaho – Remote

💵 $60.2k - $72.5k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

⚙️ Operations

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Navitus Health Solutions

WebsiteLinkedInAll Job Openings

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.

📋 Description

• Request historical files from advisor or client, and review layout as needed. • Host the TPA implementation meetings. • Review data transmission process, file layouts, timing, etc.. • Determine system hierarchy requirements and build in CRM. • Coordinate eligibility test files, updates, and production. • Coordinate claims extracts with all vendors (TPA, stop loss, advisor). • Coordinate ID card from TPA for approval. • Validate eligibility files and extracts post go live. • Conduit to the Navitus eligibility and claims extract teams. • Manage data sharing policies and Non-Disclosure Agreements with vendors. • Submit data and service requests, and ongoing monitoring to ensure accurate, timely completion. • Troubleshoot any vendor issues to ensure quick resolution, including support of the account teams in helping to facilitate resolution of escalated file issues. • Suggest and implement new vendor management processes, policies, and methods as needed. • Identify and research expansion opportunities, in addition to the growing the client base with existing consultant/broker/TPA relationships. • Other duties as assigned

🎯 Requirements

• Bachelor's degree in Business, Marketing, or related area preferred. • 3 years of vendor management experience (TPA’s, Consultants, Brokers, etc.), and working with external clients preferred. • Knowledge of PBM or health care industry preferred. • PC skills such as Microsoft Office, Email, etc. • Participate in, adhere to, and support compliance program objectives • The ability to consistently interact cooperatively and respectfully with other employees.

🏖️ Benefits

• 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!