Coordinator, Accumulator

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._____________________________________________________________________________________________________________________________________________________________________________________________________________. Current associates must use SSO login option at https://employees-navitus.icims.com/ to be considered for internal opportunities. ____________________________________________________We are committed to providing equal employment opportunity to all applicants and employees and comply with all applicable nondiscrimination regulations, including those related to protected veterans and individuals with disabilities. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, or handicap.

Pay Range

USD $20.19 - USD $23.75 /Hr.

STAR Bonus % (At Risk Maximum)

0.00 - Ineligible

Work Schedule Description (e.g. M-F 8am to 5pm)

M-F 8am-5pm

Remote Work Notification

ATTENTION: Navitus is 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.

Overview

Navitus Health Solutions is seeking a Coordinator, Accumulator to join our team!

 

The Coordinator, Accumulator 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. This role is responsible for the ongoing management of client accumulator processes and will function as the lead accumulator resource for assigned clients, as well as a back-up resource for peer coordinators when needed.  

This position may include after-hour and/or weekend hours depending on workload. 

 

Is this you? Find out more below!  

Responsibilities

How do I make an impact on my team?   

• Oversees, manages, and maintains accumulator data, processes and services for clients of low to moderate complexity. This includes understanding client needs, plan designs, monitoring of electronic file loads and subsequent reports and any additional accumulator related processes.
• Performs accumulator updates timely and accurately to prevent member access to care issues, missed performance guarantees and potential liquidated damages.
• Works directly with client contacts and supports internal customers by participating in client meetings, audits and new program implementations with other areas of the company, answering accumulator questions and providing guidance to other areas and roles on accumulator processes.
• Requests, validates and confirms full file data feeds from clients to ensure system integrity through audits and reconciliation. 
• Collaborates directly with client and/or Client Services team to report data file errors and accumulator reconciliation results on an agreed upon client schedule.
• Independently assesses business needs and participates in process improvement, cost reduction and automation efforts.
• Educates others on the accumulator process, providing talking points for Member Services to explain accumulators to members and pharmacies, and to Client Services and Government Programs to explain corrective outcomes.
• Conducts system enhancement and regression testing of a low to moderate level of complexity for accumulator related processes to ensure compliance with state, federal and client regulations/standards.
• Assists in the creation and ongoing maintenance of departmental training materials, work instructions and policies.
• Other duties as assigned 

Qualifications

What our team expects from you?  

• Associate’s degree or equivalent work experience required.  
• Minimal experience and/or training to begin learning skills, systems, and processes of the role with ability to perform tasks with close supervision.
• Basic experience with Microsoft Office, specifically Word and Excel.
• 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? 

• 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
• Educational Assistance Plan and Professional Membership assistance
• Referral Bonus Program – up to $750! 

#LI-Remote

Location : Address

Remote

Location : Country

US