Supervisor, UM Program Support - Navitus Health Solutions, LLC

Company:NavitusAbout 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 $58,460.00 - USD $70,434.00 /Yr.Work Schedule Description (e.g. M-F 8am to 5pm):M-F 8am to 5pmOverview:

Navitus Health Solutions is seeking a Supervisor, UM Program Support to join our Prior Authorization department! 

 

The Supervisor, Utilization Management (UM) Program Support will be responsible for a subset of products and tasks in support of the UM Program.  The supervisor will have ownership of the following functions: UM Notification System Configuration & Fulfillment and UM Program Audit & Quality Support. The supervisor will be required to build and maintain relationships with internal and external partners and vendors. 

 

The supervisor will be responsible for managing their direct reports, and to administer and oversee their assigned suite of UM products. The supervisor will gain an industry understanding of these products, understand Navitus’ current state and improve these products for internal and external benefit. The supervisor will interface with vendors, clients, and internal stakeholders to understand needs and areas for improvement. The supervisor will understand Navitus’ cost on assigned products, their profitability, and competitiveness within the marketplace.  

 

Is this you? Find out more below!  

Responsibilities:

How do I make an impact on my team?   

• Coordinate and oversee the following functions within the UM Program: UM Fulfillment, Failed Fax Triage, Outreach Management (vendor, client, and prescriber), UM Notification System Configuration, Audit Support, Pharmacy Notifications, Quality Assurance (QA) processes, Resource Planning and Forecasting 
• Analyze product-specific data associated with the various UM products such as: budgeting for processes, forecasting supply needs 
• Manage vendor relationships with: printer vendor, mail software vendor, mail machine vendor, and supply vendor(s). This includes budgeting, invoicing, contract review and finding/evaluating new vendor relationships 
• Recruit, maintain, and manage a high performing multi-disciplinary team consisting of: Coordinator(s), Sr. Coordinator(s) and Analyst(s). This includes managing temporary employees, whenworkloadnecessitatesadditional staff 
• Keep current with CMS (Medicare and Medicaid), Federal Exchange, state, CMS, URAC/NCQA accreditation regulations, and other regulations and guidance as they relate to the notification standards and fulfillment requirements, to ensure Navitus stays compliant with notification regulations 
• Develop and continually improve operational process to align with best-in-class strategy 
• Ensure resources are aligned with meeting timeliness requirements of operational processes 
• Assess operational capacity and capabilities for managing new clients 
• Lead development of products in a way designed to foster teamwork and maintain an outstanding customer service culture, including internal customers 
• Provide guidance, feedback and coaching to direct reports 
• Other duties as assigned 

Qualifications:

What our team expects from you?  

• Minimum of a Bachelor’s Degree 
• Experience and expertise in working across multiple departments, technical and business acumen, and a “track record” of tangible success, including leadership and team collaboration/relationship-building/management is essential 
• Must be able to exercise appropriate judgment as necessary.  Requires a high level of initiative and creativity. Experience managing direct reports is 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. 

 

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