Analyst, Benefit Configuration

🕒 il y a 7 jours

🐻 Alaska, Hawaii, +11 états de plus – Distant

🐻 Alaska – Remote 🌺 Hawaii – Remote 🦞 Maine – Remote 🗻 New Hampshire – Remote 🌶️ New Mexico – Remote 🌾 North Dakota – Remote 🎸 Mississippi – Remote ⚓ Rhode Island – Remote 🌴 South Carolina – Remote 🗿 South Dakota – Remote ⚔️ Virginia – Remote ⛰️ West Virginia – Remote 🦬 Wyoming – Remote

💵 $20 - $23 / heure

⏰ Temps Plein

🟡 Intermédiaire

🟠 Senior

🧐 Analyste

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Navitus Health Solutions

Site WebLinkedInTous les Emplois

1001 - 5000 employés

Fondée en 2003

⚕️ Assurance santé

💊 Pharmaceutique

🤝 B2B

Healthcare Insurance • Pharmaceuticals • B2B

Navitus Health Solutions est un gestionnaire de prestations pharmaceutiques (PBM) qui propose des solutions transparentes et centrées sur les personnes pour les prestations pharmaceutiques, à destination des régimes de santé, des employeurs, des programmes gouvernementaux et d'autres parrains de régimes. L'entreprise opère sur un modèle de passage intégral à un coût majoré, qui met l'accent sur la réduction des coûts des médicaments, la gestion des formulaires, la gestion des médicaments spécialisés (y compris une pharmacie spécialisée à coût majoré), l'évaluation des réclamations, la gestion du réseau de pharmacies, ainsi que l'activation et le support des membres. Navitus se positionne comme un partenaire fiduciaire axé sur l'accessibilité, la conformité, la qualité clinique, et l'amélioration des résultats de santé grâce à des services PBM sur mesure et à des intégrations de santé numérique.

Description

• Completes scheduled and urgent benefit additions, terminations, and changes timely and accurately to prevent member access to care issues, missed performance guarantees and potential liquidated damages. • Acquires and maintains a basic level of knowledge and interpretation of multiple adjudication system screens and functions on a field-by-field level to design both standard and custom configurations to meet client expectations. • Complies with standards set forth regarding benefit design and configuration including HIPAA, NCPDP and Navitus internal business standards. • Performs quality assurance peer reviews and uses sound business judgment and expertise to contribute toward the creation of root cause analysis of issues. • Uses departmental workflow management, issue resolution and reporting tools for troubleshooting and responding to general customer questions and issue resolution requests. • Supports internal customers by participating in client meetings, audits and new program implementations with other areas of the company, answering benefit setup questions and providing guidance to other areas and roles on the benefit configuration process. • Adapts to industry changes and evolving technology, maintaining a basic level of understanding of both legacy and emerging products and systems. • Independently assesses business needs and participates in process improvement, cost reduction and automation efforts. • Contributes to the creation and ongoing maintenance of departmental training materials, work instructions and policies. • 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. • Contributes to training and maintains a mentoring relationship with new and existing benefit configuration team members. • Participate in, adhere to and support compliance and diversity, equity, and inclusion program objectives. • Other duties as assigned.

🎯 Exigences

• Associate’s degree or equivalent work experience required • Minimal experience and/or training to begin learning skills, systems, and processes of the role with ability to perform tasks with close supervision • Basic experience with Microsoft Office, specifically Word and Excel • Participate in, adhere to, and support compliance program objectives • The ability to consistently interact cooperatively and respectfully with other employees.

🏖️ Avantages

• 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!