WI3652506

1

Bachelor's Degree

Bachelors Degree

$75287 + yearly

Unspecified

40

JOB REQUIREMENTS: 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. 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. The Medicaid
Product Manager (MPM) will be responsible for providing regulatory
support for the Navitus Medicaid program. The Product Manager (MPM) will
facilitate efforts to develop and implement various Medicaid process
changes according to the requirements defined by the Center for Medicare
and Medicaid Services (CMS) and each State regulating entity. The MPM is
responsible for reviewing and acting upon all CMS and State guidance
related to these functions, including technical guidance as well as
business process-related guidance. The MPM must work closely with all
key functional areas that administer certain Medicaid functions,
including but not limited to Implementation, Formulary Administration,
Provider Services, Clinical and Client Services departments. Is this
you? Find out more below! How do I make an impact on my team? Develops
and maintains deep subject matter expertise related to CMS and State
Medicaid requirements for provider materials, formulary/PDL, coverage
determinations, grievances and appeals, customer care and pharmacy
helpdesk, third party liability, 340B, and reporting Facilitates and
oversees the implementation and maintenance of Medicaid functional
processes for all Managed Medicaid clients Develops the necessary
project plans and lead projects that enhance the Medicaid operational
infrastructure Participates in state sponsored meetings as requested and
disseminates information throughout Navitus Monitors CMS and State
regulations, guidance, and system changes Ensures the Medicaid functions
meet all regulatory requirements. Responsible for operational oversight
of the Navitus Managed Medicaid product line Provides subject matter
expert support to Navitus Client and Clinical Services Executives
representing the client Assists with engaging the Program Manger with
all non-compliance related issues and/or when obstacles arise Supports
compliance efforts including State, CMS audits and client delegation
audits Supports the development of maintenance of product documentation,
including training materials Assists the Program Manager in reviewing
and managing updates to State contracts,\... For full info follow
application link. Navitus Health Solutions is an Equal Opportunity
Employer: Disabled/Veterans/Male/Female/Minority/Other \*\*\*\*\*
APPLICATION INSTRUCTIONS: Apply Online: ipc.us/t/A335B44178E94576