Returning Candidate? Log back in! Analyst, Benefit Configuration Location US-WI-Appleton ID 2024-4096 Category Administration Position Type Full-Time Remote Yes 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 $19.60 - USD $21.26 /Hr. Work Schedule Description (e.g. M-F 8am to 5pm) M-F 8am to 5pm Remote Work Notification ATTENTION: We are unable to offer remote work to residents of Alaska, Hawaii, Maine, Mississippi, New Hampshire, New Mexico, Rhode Island, South Carolina, South Dakota, West Virginia, and Wyoming. Overview

Navitus Health Solutions is seeking a Benefit Configuration Analyst to join our team! 

 

This position 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. The Benefit Configuration Analyst configures benefits in the claim adjudication system based on specifications from internal customers and external clients. This role applies knowledge of highly diverse plan designs, formularies, and networks across multiple lines of business, ensuring that claims adjudicate accurately and timely. Individuals in this role must use sound business judgement and demonstrate the ability to continually prioritize tasks, as customer experience and client financials are directly influenced by their quality of work.

 

This position may include after-hour and/or weekend hours with other eligible team members depending on workload.

 

Is this you? Find out more below!

Responsibilities Completes scheduled and urgent benefit additions, terminations, and changes timely and accurately to prevent member access to care issues, missed performance guarantees and potential liquidated damagesAcquires and maintains a basic level of knowledge and interpretation of multiple adjudication system screens and functions on a field-by-field level to design both standard and custom configurations to meet client expectationsComplies with standards set forth regarding benefit design and configuration including HIPAA, NCPDP and Navitus internal business standardsPerforms quality assurance peer reviews and uses sound business judgment and expertise to contribute toward the creation of root cause analysis of issuesUses departmental workflow management, issue resolution and reporting tools for troubleshooting and responding to general customer questions and issue resolution requestsContributes to the creation and ongoing maintenance of departmental training materials, work instructions and policiesConducts system enhancement and regression testing of a low to moderate level of complexity for benefit configuration processes to ensure compliance with state, federal and client regulations/standardsOther duties as assigned Qualifications

What our team expects from you?

Associate degree or equivalent work experienceBasic experience with Microsoft Office, specifically Word and ExcelParticipate in, adhere to, and support compliance program objectivesThe ability to consistently interact cooperatively and respectfully with other employeesWhat 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

 

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.

Location : Address 1025 West Navitus Dr.  Location : City Appleton Location : State/Province WI Location : Postal Code 54913 Location : Country US Options ApplyApplySubmit a ReferralRefer Sorry the Share function is not working properly at this moment. Please refresh the page and try again later. Application FAQs

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