Product Manager, Med-D

🕒 il y a 6 jours

🏈 Alabama, Arizona, +33 états de plus – Distant

🏈 Alabama – Remote 🌵 Arizona – Remote 🏄 California – Remote ⛰️ Colorado – Remote 🦌 Connecticut – Remote 🐊 Florida – Remote 🥔 Idaho – Remote 🌽 Illinois – Remote 🌾 Iowa – Remote 🌪️ Kansas – Remote 🐎 Kentucky – Remote ⚜️ Louisiana – Remote 🦬 Montana – Remote 🌾 Nebraska – Remote 🎰 Nevada – Remote 🏖️ New Jersey – Remote 🗽 New York – Remote 🌲 North Carolina – Remote 🏈 Ohio – Remote 🌪️ Oklahoma – Remote 🌲 Oregon – Remote 🦀 Maryland – Remote 🍂 Massachusetts – Remote 🚗 Michigan – Remote ❄️ Minnesota – Remote 🏰 Missouri – Remote 🔔 Pennsylvania – Remote 🎸 Tennessee – Remote 🤠 Texas – Remote ⛷️ Utah – Remote 🍁 Vermont – Remote ⚔️ Virginia – Remote ☕ Washington – Remote 🧀 Wisconsin – Remote 🍑 Georgia – Remote

💵 $79 872 - $98 003 / an

⏰ Temps Plein

🟡 Intermédiaire

🟠 Senior

✅ Responsable Produit

👻 Score fantôme 0%

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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

• Provide product management for the Navitus Medicare Part D program • Lead efforts to design, develop, implement, and oversee Medicare Part D processes supporting regulatory requirements and client expectations • Review and act upon CMS technical and business process/operational guidance • Ensure appropriate software, processes/procedures, and oversight monitoring are implemented • Develop and maintain subject matter expertise related to Medicare Part D rules and regulations • Monitor and interpret CMS regulations, guidance, and system changes • Manage development, implementation, and maintenance of Medicare Part D processes for all Medicare Part D clients • Develop project plans and lead projects enhancing the Medicare Part D program • Implement requirements using project management tools and principles • Establish stable processes and effective monitoring mechanisms • Perform operational oversight for services delegated by Medicare Part D clients and align oversight with identified risks • Identify and implement process improvements to improve efficiency, automation, scalability, and compliance/risk mitigation • Implement corrective actions addressing compliance issues and ensure root-cause correction and monitoring • Support CMS audits and client oversight audits • Provide subject matter expert support to the organization and Med D clients • Support Sales efforts with Medicare Part D-specific RFP responses as needed • Ensure policies and procedures document compliance with Part D/regulatory requirements • Perform oversight to ensure guidance citations are accurate and current • Conduct periodic audits of functional-area performance • Perform other duties as assigned

🎯 Exigences

• Bachelor’s degree or equivalent work experience in Medicare Part D required • 3 years of Medicare Part D experience required • Expertise in Medicare Part D regulations and demonstrated accountabilities in areas such as coverage determinations, appeals and grievances, prior authorizations, formulary management, transition monitoring, etc. is preferred • Experience in government program compliance oversight and CMS audit protocol highly desired • 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!

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