
1001 - 5000 employees
Founded 2003
⚕️ Healthcare Insurance
💊 Pharmaceuticals
🤝 B2B
Healthcare Insurance • Pharmaceuticals • B2B
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.
🔥 2 minutes ago
🥔 Idaho – Remote
💵 $63.8k - $76.9k / year
⏰ Full Time
🟡 Mid-level
🟠 Senior
🔧 QA Engineer (Quality Assurance)
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1001 - 5000 employees
Founded 2003
⚕️ Healthcare Insurance
💊 Pharmaceuticals
🤝 B2B
Healthcare Insurance • Pharmaceuticals • B2B
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.
• Oversee roles within the Quality Assurance team to support accurate and timely configuration and data transfers of client hierarchy, benefits, and networks. • Provide superior customer service utilizing a high-touch, customer centric approach focused on collaboration and communication. • Ensure team efforts delight the customer. • Cultivate a positive team atmosphere. • Outreach and collaborate with business partners for day-to-day work and contribute to action plan creation. • Partner with Sr. Manager to support client relationships across multiple lines of business and various complexity levels. • Oversight of work on Kanban boards, meeting turnaround times, and performance guarantees. • Run department Kanban board(s) and huddles, including sizing of work requests. • Responsible for capacity reporting and production control numbers. • Populate client trackers regarding status of requests, barriers, and resolution for service excellence. • Resource assignment of day-to-day work, audits, and root cause analysis/CAP. • Address barriers of direct reports by guiding and influencing discussions while maintaining a forward-thinking approach. • Maximize the skillset of the department through volumes of high workload to maintain claim adjudication accuracy for client and member satisfaction. • Responsible for performance measures and workload monitoring of direct reports. • Perform 1:1s to elicit feedback from department associates, provide mentorship, discuss career development, address performance, and provide workload and project guidance. • Address escalations from direct reports, along with contributing to action plans. • Perform workforce management duties for direct reports, including, but not limited to, overtime needs, time out of the office and time tracking. • Provide technical/operations support for audits involving configuration and/or data file information. • Other duties as assigned.
• Bachelor’s degree or equivalent work experience is required. • 4 years of relevant experience required. • Knowledge of one or more responsibilities as defined above is strongly preferred. • Professional PBM industry work experience is preferred. • Knowledge of applicable data privacy practices and laws is preferred. • Healthcare industry practices and HIPAA knowledge would be a plus. • Experience as a member of a multi-disciplinary team is a plus. • Understanding of human resource management principles, practices, and procedures would be a plus. • Participate in, adhere to, and support compliance program objectives. • The ability to consistently interact cooperatively and respectfully with other employees.
• 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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