Configuration Analysis Supervisor jobs in Appleton, WI

Pharmacy Benefits Reinvented- As the industry’s alternative pharmacy benefit manager (PBM), we’re committed to making prescriptions more affordable for you and your members. Here at Navitus, our team members work in an environment that celebrates creativity, fosters diversity and encourages growth. We welcome new ideas and share a passion for excellence.   

The Benefit Configuration Tester I test’s configuration and maintenance activities of Navitus Benefit Configuration Analysts (BCA) who are responsible for the configuration of Navitus’ pharmacy claims processing system. The primary functions of the Benefit Configuration Tester I involve performing the necessary configuration testing ensuring Navitus is able to set up and maintain a versatile claims adjudication system

Is this you? Find out more below!

How do I make an impact on my team?  

• Provide superior customer service utilizing a high-touch, customer centric approach focused on collaboration and communication
• Analyze and test requests including pharmacy network rates and formulary management configuration with a high degree of accuracy
• Mitigate the risk of errant adjudication of claims, especially those with a financial impact to Navitus, members, clients, or pharmacies
• Acquire understanding of Navitus’ claims adjudication system and upstream/downstream processes
• Execute batch testing where applicable
• Is responsible for complying with departmental standards along with established turnaround times
• Comply with standards set forth regarding benefit design and configuration including HIPAA, NCPDP, and Navitus internal business standards
• Utilize departmental work flow management, issue resolution, and reporting tools
• Contribute toward departmental performance and service level guarantees and achieve individual performance goals around accuracy and timeliness
• Assist in the development of process improvements that focus on efficiency and accuracy
• Ability to communicate effectively at all levels within the organization (written, verbal/presentation, and active listening)

What our team expects from you? 

• Associate degree or equivalent work experience is required
• Two years previous work experience
• PBM or managed care is preferred, but not required
• Previous testing experience is preferred
• Two years of Excel formula and/or macro experience is a plus
• 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, Eight paid holidays, 401K, Short-term and Long-term disability, Paid Parental Leave, Adoption Assistance Program, and Employee Assistance Program