Systems and Quality Analyst Manager

Navitus

About Us

Navitus - Putting People First in Pharmacy - Navitus was founded as an alternative to traditional pharmacy benefit manager (PBM) models. We are committed to removing cost from the drug supply chain to make medications more affordable for the people who need them. At Navitus, our team members work in an environment that celebrates diversity, fosters creativity and encourages growth. We welcome new ideas and share a passion for excellent service to our customers and each other.

Pay Range

USD $112,640.00 - USD $140,800.00 /Yr.

Work Schedule Description (e.g. M-F 8am To 5pm)

M-F 8am-5pm, CST

Overview

Due to growth, we are adding Systems and Quality Analyst Manager to our team .

The Systems and Quality Analyst Manager will provide support for the development, implementation, and maintenance of our FFS Medicaid products. The FFS implementations require full compliance to NCPDP standards, CMS and State regulations and with defined business rules and policies. The Systems and Quality Analyst Manager will be responsible for managing the activities during the DDI and the life of the contract to ensure the system meets all requirements set forth.

Is this you? Find out more below!

Responsibilities

How do I make an impact on my team ?

• Develop and maintain deep knowledge of NCPDP pharmacy POS claims processing requirements.
• Develop an understanding of unique attributes within a claim transaction where contracted State governments apply specific regulatory requirements to support their programs.
• Understand the competitive landscape, regulatory lifecycle and related government processes surrounding FFS.
• Facilitate productive discussions to identify, confirm and resolve any identified quality issues and stay engaged through complete resolution.
• Perform testing design and delivery requirements. Engages with state agents on quality validation outcomes and/or demonstrations.
• Work with the team to identify, analyze, quantify, and mitigate risks.
• Work with the project management office to utilize and enhance tools that support the requirements, development, and testing processes.
• Some travel and on-call availability may be required.
• Other duties as assigned
  
  

Qualifications

What our team expects from you?

• Bachelor’s degree preferred; relevant certifications from recognized industry organizations preferred.
• Four years of POS systems operations experience as manager in a state of equivalent scope to Iowa.
• Three years progressive experience in the quality assurance function of a large-scale claims processing organization.
• Bachelor’s degree in information system engineering, Computer Science, or a related field, with at least three courses in Statistics and or Quality Assurance is desired.
• Experience in roles like a Business Analyst, Business Systems Analyst, or Product Manager.
• Strong oral communication skills including product presentation and communication with all levels 5 years of Business Analyst experience with 2-3 years of experience in Pharmacy Claims required.
• Elicitation and documentation of Medicaid Business requirements.
• Implementation of government regulations into software development activities.
• Participating in an agile development project team.
• Experience with core software applications, including Microsoft Word and Excel.
• Knowledge of Software Development Lifecycle (SDLC) methodologies.
• Experience with Microsoft Visio, PowerPoint, Project and Team Foundation Server (TFS) preferred.
• Healthcare industry business practices and HIPAA knowledge preferred.
• Working experience with pharmacy benefits and claims processing preferred.
• Experience in mockups, wireframing and prototyping UI with UX principles preferred.
• Experience with multiple testing methodologies preferred.
• Business Analysis Certification (PMI, IIBA) or College level program preferred.
• Participate in, adhere to, and support compliance program objectives
• The ability to consistently interact cooperatively and respectfully with other employees
  
  

What can you expect from Navitus?

• 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!
  
  

We are unable to offer remote work to residents of Alaska, Hawaii, Maine, Mississippi, New Hampshire, New Mexico, North Dakota, Rhode Island, South Carolina, South Dakota, West Virginia, and Wyoming.