Navitus

Navitus Health Solutions is seeking a Sr. Software Developer to join their team to define, design, develop, test, analyze, and maintain new and existing applications in support of the achievement of business requirements. This includes designing, documenting, coding, testing, and analyzing software programs and applications. The role also includes researching, designing, documenting, and modifying software specifications throughout the production life cycle.

Navitus Health Solutions is seeking an Operations Manager, Medicare Part D to join our Government Programs Team! As part of this team, you'll lead the group responsible for Navitus’ Medicare EGWP Product operational processes, ensure successful project completion, and provide ongoing support for resulting processes, interfacing with multiple teams.

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 activities during the DDI and the life of the contract to ensure the system meets all requirements set forth.

The Analyst, Rebate Operations is responsible for analyzing, understanding, and implementing PBM to pharmaceutical manufacturer or GPO rebate submission and reconciliation processes. This individual will work closely with the Manager of Rebate Operations to assure complete accurate and timely claim data submissions to Prime Therapeutics. In addition, the Analyst will assure rebate submission standards are met, rebate payments are reconciled and investigate and resolve any discrepancies.

Navitus Health Solutions is seeking a Grievance and Appeals Coordinator to join our team! Serve as a liaison for members, prescribers and pharmacies regarding complaints or appeals related to denied pharmacy claims, membership and benefit issues, reimbursements and quality of care or service. Responsible for presentation of the member appeals as required.

The Quality Control Analyst (QCA) is responsible for supporting and coordinating quality control analysis and related processes for activities performed by Navitus Health Solutions, engaging in preventive and detective quality controls that can be measured quantitatively and qualitatively to validate Navitus processes. The QCA I will work with oversight and moderate independence to ensure quality control validations are completed in a timely manner.

Navitus Health Solutions is seeking a Telehealth RN Case Manager to join our team. The Telehealth RN Case Manager will improve member’s health and wellness via tele-pharmacy and wellness coaching. This Telehealth RN is responsible for the delivery of the Medication Therapy Management (MTM) services for commercial and Medicare members and will assist in the development and execution of additional clinical outreach programs.