Supervisor, UM Reporting

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 $61,968.00 - USD $74,660.00 /Yr.

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

M-F 8am-5pm, CST

Overview

Due to growth we are adding a UM Reporting Supervisor to our Prior Authorization department!

 

The Supervisor, UM Reporting will have ownership and oversight of Utilization Management reporting and analytics. In coordination with the Sr Manager, UM Operations, the Supervisor will develop and maintain the long term and immediate roadmap for UM Reporting. The Supervisor will gain an industry and regulatory understanding of UM reporting, understand Navitus’ current state and improve reporting for internal and external benefit. The Supervisor will interface with clients and internal stakeholders to understand needs and areas for improvement.

 

Is this you? Find out more below!

Responsibilities

How do I make an impact on my team?

• Supervise UM Reporting team. Create and maintain training instructions for all roles. Train new team members on the UM reporting procedures. • Oversee the setup and maintenance of Navitus’ UM reports for all lines of business (Commercial, Exchange, Medicaid, and Medicare).• Manage reports that meet regulatory requirements including but not limited to: Centers for Medicare and Medicaid Services (CMS), National Committee for Quality Assurance (NCQA), Utilization Review Accreditation Commission (URAC). This includes speaking to these reports during regulatory audits.• Act as product owner for Navitus’ UM reports.• Develop and maintain the long and immediate term roadmap for assigned systems.• Ensure reporting capabilities continue to function as intended and is scalable to Navitus’ clients. • Create and update logic for new reports, and test new reports for accuracy • Other duties as assigned

Qualifications

What our team expects from you?

• Bachelor’s degree in a business, analytics, mathematics or relevant related field, or equivalent work experience is required. • Experience with creating reports, building report logic, conducting data quality assurance, and a track record of tangible success is required. • Experience in formal/informal leadership and team collaboration/relationship-building/management is required. • Experience with prior authorization or PBM knowledge required.• Experience with program audits and quality is preferred.• Participate in, adhere to, and support compliance program objectives • The ability to consistently

 

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

 

 #LI-Remote

Location : Address

Remote

Location : Country

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