Advisor, Industry Standards

Job not on LinkedIn

🔥 0 minutes ago

🐻 Alaska, Hawaii, +12 more states – Remote

🐻 Alaska – Remote 🌺 Hawaii – Remote 🥔 Idaho – 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

💵 $75k - $92k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

🚫👨‍🎓 No degree required

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

Navitus Health Solutions

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 2003

💼 Consulting

🛡️ Insurance

🏥 Healthcare

Consulting • Insurance • Healthcare

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

• Participate in NCPDP Task Groups and Work Groups to represent Navitus’ perspective on proposed new standards and modifications to existing standards • Engage directly with clients and auditors as a subject matter expert and strategic consultant • Build industry networking relationships to collaborate on NCPDP standards and processes • Summarize applicable NCPDP standards and present impacts to Navitus leadership and departments • Provide subject matter expertise for functional and business requirements for the claims adjudication platform • Research issues, collaborate with internal and external customers to resolve them, and oversee corrective actions • Develop detailed knowledge of claims adjudication system capabilities and limitations • Review prescription benefit standards changes and translate them into business and system requirements • Facilitate pharmacy testing for NCPDP compliance, including test plans and payer sheet updates • Perform other duties as assigned

🎯 Requirements

• Minimum 2 years’ work experience in PBM Operations required • NCPDP member and standards expertise with active participation in NCPDP work groups and task groups preferred • PBM industry experience required • Experience in review and interpretation of complex regulatory guidance • Participate in, adhere to, and support compliance program objectives • 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% with no vesting requirement • Adoption Assistance Program • Flexible Spending Account • Educational Assistance Plan and Professional Membership assistance • Referral Bonus Program – up to $750!