Operations Manager, Medicare Part D

Company

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 $93,671.10 - USD $114,934.20 /Yr.

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

Monday - Friday 8am-5pm CST

Overview

As part of the Government Programs Team and reporting to the General Manager, Medicare Part D, the Operations Manager, Medicare Part D administers operational responsibilities on behalf of Navitus’ Medicare Product and implements systemic process and systems updates based on CMS regulatory changes for all Navitus Part D clients. The Manager will ensure success completion of projects led by the team, implement and administer processes that govern those projects, and is responsible for ongoing operational processes. This position will interface primarily with the Government Programs Medicare Functional Product Team, Technical Operations Team, Part D Compliance Team, and Client Account Management.

 

Is this you? Find out more below! 

Responsibilities

How do I make an impact on my team?

• Develops and maintains a project portfolio infrastructure for all projects executed by the team.
• Develops and maintains knowledge of Medicare Part D requirements for operational functions to facilitate identification of requirements for development and assures compliant business operations.
• Reads Centers for Medicare & Medicaid Services (CMS) Proposed and Final Rules related to Medicare Part D. Ensures successful completion of projects led by the team that meet the requirements outlined in these Rules.
• Oversees EGWP product management operational support activities. Resolves escalated issues arising from operations and coordination with other departments.
• Actively participates in the largest annual project led by the team, the annual member materials project.
• Manages a matrix of operational processes to assigned resources. Ensures detailed work instructions are developed and maintained. Manages workload of team members and continually balances priorities with available resources.
• Establishes processes that are scalable and efficient. Identifies key metrics to monitor the compliance and accuracy of the processes establishing oversight methods that are operationally efficient and effective.
• Leads activities related to annual plan submission of our EGWP plans to CMS, including being proficient in use of the HPMS system.
• Oversees all EGWP client implementations and re-implementations.
• Develops and maintains subject matter expertise related to the Medicare Advantage and Part D Communications & Marketing Guidelines and general Medicare Part D topics as it relates to the content in the annual beneficiary materials.
• Provides SME support to Navitus Sales Team and Proposal Team for functions supported by the team.
• Participates in, adheres to and supports compliance and diversity, equity, and inclusion program objectives.
• Other duties as assigned.

Qualifications

What our team expects from you? 

• A minimum of a Bachelor’s Degree is required
• 5+ years of experience in project management experience in a Medicare health plan or PBM required.
• Project portfolio management experience preferred.
• Strong leadership skills and/or management experience required, defined as prior experience supervising or managing people and indirectly leading teams.
• Experience in interpreting and articulating regulatory requirements.
• Experience with interfacing with external clients.
• 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.  

#LI-Remote

 

 

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Remote

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