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Navitus Health Solutions
Navitus Health Solutions
1 001 – 5 000 Darbuotojai
DraudimasKonsultavimasSveikatos priežiūra
„Navitus Health Solutions“ yra į sveikatos priežiūrą orientuota vaistų išmokų administravimo įmonė, teikianti paslaugas sveikatos planams, darbdaviams, vyriausybinėms programoms ir kitiems planų rėmėjams. Jos vaistų išmokų paslaugos apima vaistų sąrašo ir specialiųjų vaistų valdymą, žalos atlyginimo paraiškų administravimą, vaistinių tinklo priežiūrą, narių aptarnavimą ir skaitmeninės sveikatos integracijas. Įmonė taiko 100 proc. lėšų perdavimo, sąnaudų ir antkainio modelį ir bendradarbiauja su planų rėmėjais kaip fiduciarinis partneris, daugiausia dėmesio skiriantis vaistų prieinamumui, teisės aktų laikymuisi, klinikinei kokybei ir geresniems sveikatos rezultatams.
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PBM Contract Operations Analyst (Remote, U.S.)

Support Lumicera’s specialty pharmacy discount programs through contract operations, claims analysis, rebates, audits, forecasting, and client reporting.

USJungtinės ValstijosALAlabamaAZArizonaCAKalifornijaCOKoloradasFLFloridaILIlinojusIAAjovaLALuizianaMDMerilandasMIMičiganasMNMinesotaMOMisūrisNENebraskaNVNevadaNJNaujasis DžersisNYNiujorkasNCŠiaurės KarolinaOHOhajasOKOklahomaOROregonasPAPensilvanijaTNTenesisTXTeksasasUTJutaVAVirdžinijaWAVašingtonasWIViskonsinas
60 214 $ – 72 547 $ / metai
NuotolinisVisas etatasVidutinis lygisVyresnysis specialistasPrivaloma Kalba: anglųOperacijos

Aprašymas

  • Assess plan formulary designs and contracting options for client-specific arrangements.
  • Analyze claims to verify contract processing and recommend opportunities to optimize contracts.
  • Support sales and RFPs for prospective clients, renewals, and market reviews.
  • Work with Finance and Underwriting to evaluate contracts and manage pricing risk.
  • Review, enter, evaluate, and reconcile client contract financial guarantees.
  • Provide information that supports business decisions.
  • Act as the Client Services contact for contract reports, guarantee questions, and data analysis.
  • Coordinate with Analytics on contract reporting systems.
  • Support new contract program initiatives and expanded contract forecasting.
  • Provide subject matter expertise for internal, external, manufacturer, client, and regulatory audits.
  • Lead and coordinate government and other regulated reporting.
  • Review discount strategies and pharmaceutical manufacturer contracts, maintain contract processing parameters, and allocate payments.
  • Handle other duties as assigned.

Reikalavimai

  • A bachelor’s degree is required.
  • Three to five years of experience in managed care, pharmacy benefit management, or pharmaceuticals is required.
  • A pharmacy technician license is preferred.
  • Pharmacy technician, trade, industry relations, and/or analytical experience is preferred.
  • Experience with PBMs and rebate analytics.
  • Ability to understand plan formulary design and contracting options.
  • Ability to analyze claims data.
  • Ability to support contract review, data entry, evaluation, and reconciliation.
  • Ability to participate in and support compliance program objectives and adhere to them.
  • Ability to interact consistently and respectfully with colleagues.

Privalumai

  • Health, dental, and vision insurance described as top-of-industry benefits.
  • 20 days of paid time off.
  • Four weeks of paid parental leave.
  • Nine paid holidays.
  • 401(k) company match of up to 5%, with no vesting requirement.
  • Adoption assistance program.
  • Flexible spending account.
  • Educational assistance and professional membership support.
  • Referral bonus of up to $750.
  • Remote work available to residents of specified U.S. states.