38 applicants
Navitus Health Solutions · 3 days ago
Systems and Quality Analyst Manager
United States
Full-time
Remote
Mid Level
$113K/yr - $141K/yr
4+ years exp
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Responsibilities
Develop and maintain deep knowledge of NCPDP pharmacy POS claims processing requirements.
Develop an understanding of unique attributes within a claim transaction where contracted State governments apply specific regulatory requirements to support their programs.
Understand the competitive landscape, regulatory lifecycle, and related government processes surrounding FFS.
Facilitate productive discussions to identify, confirm, and resolve any identified quality issues and stay engaged through complete resolution.
Perform testing design and delivery requirements. Engage with state agents on quality validation outcomes and/or demonstrations.
Work with the team to identify, analyze, quantify, and mitigate risks.
Work with the project management office to utilize and enhance tools that support the requirements, development, and testing processes.
Some travel and on-call availability may be required.
Other duties as assigned
Qualification
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Required
Bachelor’s degree preferred; relevant certifications from recognized industry organizations preferred.
Four years of POS systems operations experience as manager in a state of equivalent scope to Iowa.
Three years progressive experience in the quality assurance function of a large-scale claims processing organization.
Bachelor’s degree in information system engineering, Computer Science, or a related field, with at least three courses in Statistics and or Quality Assurance is desired.
Experience in roles like a Business Analyst, Business Systems Analyst, or Product Manager.
Strong oral communication skills including product presentation and communication with all levels 5 years of Business Analyst experience with 2-3 years of experience in Pharmacy Claims required.
Elicitation and documentation of Medicaid Business requirements.
Implementation of government regulations into software development activities.
Participating in an agile development project team.
Experience with core software applications, including Microsoft Word and Excel.
Knowledge of Software Development Lifecycle (SDLC) methodologies.
Participate in, adhere to, and support compliance program objectives
The ability to consistently interact cooperatively and respectfully with other employees
Preferred
Bachelor’s degree in information system engineering, Computer Science, or a related field, with at least three courses in Statistics and or Quality Assurance is desired.
Experience with Microsoft Visio, PowerPoint, Project and Team Foundation Server (TFS) preferred.
Healthcare industry business practices and HIPAA knowledge preferred.
Working experience with pharmacy benefits and claims processing preferred.
Experience in mockups, wireframing and prototyping UI with UX principles preferred.
Experience with multiple testing methodologies preferred.
Business Analysis Certification (PMI, IIBA) or College level program preferred.
Some travel and on-call availability may be required.
Other duties as assigned.
Benefits
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
Educational Assistance Plan and Professional Membership assistance
Referral Bonus Program – up to $750!
Company
Navitus Health Solutions
Navitus Health Solutions LLC is a full service, URAC-accredited pharmacy benefit management company.
1,001-5,000 employees
H1B Sponsorship
Navitus Health Solutions has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Trends of Total Sponsorships
2022 (1)
Funding
Current Stage
Late StageLeadership Team
Shayna Schulz
Chief Operations Officer
Recent News
Company data provided by crunchbase
