Benefit Configuration Analyst

🔥 13 hours ago

🇺🇸 United States – Remote

💵 $20 - $23 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

🧐 Analyst

👻 Ghost score 0%

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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

• Complete scheduled and urgent benefit additions, terminations, and changes accurately and promptly • Maintain knowledge of adjudication system screens and functions to design standard and custom configurations • Apply benefit design and configuration standards, including HIPAA, NCPDP, and Navitus internal standards • Perform quality assurance peer reviews and contribute to root cause analyses • Use workflow management, issue resolution, and reporting tools for troubleshooting and customer questions • Support client meetings, audits, and new program implementations • Answer benefit setup questions and provide guidance on the benefit configuration process • Maintain understanding of legacy and emerging products and systems • Assess business needs and participate in process improvement, cost reduction, and automation efforts • Maintain departmental training materials, work instructions, and policies • Conduct system enhancement and regression testing for benefit configuration processes • Contribute to training and mentor benefit configuration team members • Support compliance and diversity, equity, and inclusion program objectives • Work occasional after-hours and/or weekends depending on workload • Perform other duties as assigned

🎯 Requirements

• 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 • Ability to participate in, adhere to, and support compliance program objectives • Ability to consistently interact cooperatively and respectfully with other employees • Must reside in the United States, excluding Alaska, Hawaii, Maine, Mississippi, New Hampshire, New Mexico, North Dakota, Rhode Island, South Carolina, South Dakota, West Virginia, and Wyoming for remote work eligibility

🏖️ 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! • M-F 8am to 5pm schedule • Remote work