Product Manager, Med-D

🔥 5 minutes ago

🏈 Alabama, Arizona, +33 more states – Remote

🏈 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

💵 $79.9k - $98k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

✅ Product Manager

👻 Ghost score 0%

What it means: the chance that no one is really hiring for this job.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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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

• 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

🎯 Requirements

• 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

🏖️ 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!

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