FreshRemote.Work

Coordinator I, Accumulator-Remote

Appleton, WI, US | Remote, US

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.  

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.

The Accumulator Coordinator ensures efforts are in alignment with the Claim Adjudication Operations (CAO) team to leverage technology and process improvement for the purpose of meeting the business needs of Navitus customers, clients, members, and pharmacies by accurately administering benefits. This role is responsible for the ongoing management of client accumulator processes and will function as the lead accumulator resource for assigned clients, as well as a back-up resource for peer coordinators when needed. 

This position requires knowledge of both the technical and operational sides of the business. The Accumulator Coordinator will work closely with Information Technology, Benefit Configuration, Eligibility and Client Services teams to understand the interdependences of each functional area. Individuals in this role will have direct authority to make sound business decisions regarding client accumulator data and will demonstrate the ability to continually prioritize day to day workload to meet individual, departmental and organizational goals.

This position may include after-hour and/or weekend hours depending on workload. 

Is this you? Find out more below! 

How do I make an impact on my team?  

  • Oversees, manages, and maintains accumulator data, processes and services for clients of low to moderate complexity. This includes understanding client needs, plan designs, monitoring of electronic file loads and subsequent reports and any additional accumulator related processes.
  • Performs accumulator updates timely and accurately to prevent member access to care issues, missed performance guarantees and potential liquidated damages.
  • Works directly with client contacts and supports internal customers by participating in client meetings, audits and new program implementations with other areas of the company, answering accumulator questions and providing guidance to other areas and roles on accumulator processes.
  • Requests, validates and confirms full file data feeds from clients to ensure system integrity through audits and reconciliation. 
  • Collaborates directly with client and/or Client Services team to report data file errors and accumulator reconciliation results on an agreed upon client schedule.
  • Independently assesses business needs and participates in process improvement, cost reduction and automation efforts.
  • Uses sound business judgment and expertise to contribute toward the creation of root cause analysis of issues. 
  • Educates others on the accumulator process, providing talking points for Member Services to explain accumulators to members and pharmacies, and to Client Services and Government Programs to explain corrective outcomes.
  • Adapts to industry changes and evolving technology, maintaining a basic to intermediate level of understanding of both legacy and emerging products and systems.
  • Conducts system enhancement and regression testing of a low to moderate level of complexity for accumulator related processes to ensure compliance with state, federal and client regulations/standards.
  • Assists in the creation and ongoing maintenance of departmental training materials, work instructions and policies.

What our team expects from you? 

  • Associate degree or equivalent work experience
  • Basic experience with Microsoft Office, specifically Word and Excel
  • 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?

  • Hours/Location: Monday-Friday 8:00am-5:00pm, CST-Remote
  • Paid Volunteer Hours
  • Educational Assistance Plan and Professional Membership assistance
  • Referral Bonus Program – up to $750!
  • Top of the industry benefits for Health, Dental, and Vision insurance, Flexible Spending Account, Paid Time Off, Nine paid holidays, 401K, Short-term and Long-term disability, College Savings Plan, Paid Parental Leave, Adoption Assistance Program, and Employee Assistance Program

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Job Profile

Regions

North America

Countries

United States

Benefits/Perks

Adoption Assistance Adoption Assistance Program College Savings Plan Educational Assistance Educational Assistance Plan Employee Assistance Program Flexible Spending Flexible Spending Account Nine paid holidays Paid holidays Paid parental leave Paid Time Off Paid Volunteer Hours Professional Membership assistance Referral Bonus Referral Bonus Program Remote work Top of the industry benefits for Health, Dental, and Vision

Skills

Analysis Benefit Configuration Business decisions Claim Adjudication Client Services Compliance Configuration Eligibility Excel Government Programs Information Technology Microsoft Office Organizational Pharmacy Process Improvement Root Cause Analysis Technology Testing Training Word

Tasks
  • Assess business needs
  • Collaborate with clients and internal teams
  • Conduct system testing
  • Ensure compliance
  • Manage accumulator data
  • Perform accumulator updates
  • Reconciliation
Education

Associate Associate degree Business College Operations Pharmacy

Restrictions

Hawaii Maine Mississippi New Hampshire New Mexico North Dakota Not available for residents of Alaska, Hawaii, Maine, Mississippi, New Hampshire, New Mexico, North Dakota, Rhode Island, South Carolina, South Dakota, West Virginia, Wyoming Residents of Alaska, Hawaii, Maine, Mississippi, New Hampshire, New Mexico, North Dakota, Rhode Island, South Carolina, South Dakota, West Virginia, and Wyoming Rhode Island South Carolina South Dakota 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 West Virginia Wyoming

Timezones

America/Anchorage America/Chicago America/Denver America/Los_Angeles America/New_York Pacific/Honolulu UTC-10 UTC-5 UTC-6 UTC-7 UTC-8 UTC-9