Director, Network Informatics, Analytics

🕒 il y a 3 mois

🥔 Idaho – Distant

🥔 Idaho – Remote

💵 $152 077 - $190 096 / an

⏰ Temps Plein

🔴 Expert

👔 Directeur

👻 Score fantôme 34%

Ce que ça veut dire : la probabilité que cette offre reste ouverte sans recrutement actif.Comment le lire : 60 % ou plus, on pense que c'est une offre fantôme. Un score plus bas est moins inquiétant.Comment on la calcule : ancienneté, republications, postes ouverts vs taille de l'équipe, rapidité de clôture, et si le salaire est indiqué.À noter : une estimation à partir de données publiques, pas un jugement sur l'entreprise. De vraies offres peuvent avoir un score élevé, alors prenez-le comme un indice, pas comme un fait.

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Navitus Health Solutions

Site WebLinkedInTous les Emplois

1001 - 5000 employés

Fondée en 2003

💼 Conseil

🛡️ Assurance

🏥 Santé

Consulting • Insurance • Healthcare

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

• Own and evolve the informatics framework supporting pharmacy network contracting, including contract attributes, reimbursement methodologies, network hierarchies, and provider identifiers • Establish and maintain data standards, definitions, and governance controls to ensure data consistency, usability, and integrity across systems and reporting environments • Serve as the centralized authority for network and contract data quality, enabling reliable and scalable analytics • Design and develop network models to evaluate reimbursement structures, pricing strategies, and financial impact across pharmacy segments • Build analytical frameworks to assess provider cost, performance, and value (e.g., scorecards, cost-of-care, network efficiency) • Identify optimization opportunities through scenario modeling, trend analysis, and performance insights • Lead development and maintenance of standardized reporting and dashboards for network performance, reimbursement trends, and contract alignment • Deliver actionable insights through routine and ad hoc analyses, including trend identification, outlier detection, and emerging risk monitoring • Establish KPI frameworks to measure network effectiveness, cost efficiency, and overall performance across pharmacy segments • Establish and oversee analytical quality control frameworks to assess alignment between contract intent and observed claims and network performance outcomes • Develop monitoring approaches that surface discrepancies, emerging risks, or unintended financial impacts • Provide analytical insight into the performance of new network builds, contract changes, and reimbursement updates through evaluation of claims outcomes and network performance • Collaborate with Analytics, Finance, IT, Compliance, Legal, and Operations to ensure data transparency, alignment, and visibility into key issues • Support enterprise initiatives including new client implementations, regulatory changes, and network expansion strategies

🎯 Exigences

• Bachelor’s degree in Business, Finance, Analytics, Information Systems, Healthcare Administration, or related field, or equivalent work experience, required. • 7+ years of progressive experience in PBM, healthcare analytics, PBM network operations (not IT networks), pharmacy informatics or equivalent experience required. • 3+ years of leadership experience with a proven ability to develop high-performing teams and deliver tangible results in a professional services environment required. • Demonstrated experience with claims data, network configuration, reimbursement models, and complex data environments required. • Proven ability to lead analytics, reporting, or informatics functions in a regulated healthcare setting required. • Experience supporting contracting, pricing, or network management functions strongly preferred. • 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!