Returning Candidate? Log back in! Supervisor, Provider Services Location US- ID 2025-4549 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._____________________________________________________________________________________________________________________________________________________________________________________________________________. Current associates must use SSO login option at https://employees-navitus.icims.com/ to be considered for internal opportunities. Pay Range USD $61,968.00 - USD $74,660.00 /Yr. Work Schedule Description (e.g. M-F 8am to 5pm) M-F 8am-5pm, CT 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

Due to growth we are adding a Provider Services Supervisor to our team!

 

The Supervisor, Provider Services is a highly motivated professional experience working in a pharmacy or interfacing directly with pharmacies or accounts, preferably in healthcare.  Responsibilities include the oversight for executing contracts and/or credentials with pharmacies, responding to pharmacy inquiries, and completing the tactical and operational tasks required to maintain contracted pharmacy networks. The individual(s) in this position will oversee end to end operational aspects of administration, analysis, and quality assurance for network design and management. The Supervisor, Provider Services will work closely on their daily tasks with the staff. The individual (s) is accountable for ensuring data integrity of the contracts and/or credentials entered into the pharmacy network database as well as the claims processing system adjudicate pharmacy claims according to Navitus agreements and Navitus business rules. The individual(s) will maintain and monitor the team’s performance as it relates to operational duties of the department and report all performance metrics to leadership. In addition, the role of the Supervisor, Provider Services requires a deep knowledge of pharmacy processing practices, pharmacy laws and regulations, and verbal and written communication skills.

 

Is this you? Find out more below!

Responsibilities

How do I make an impact on my team? 

Point of contact with external pharmacy partners and strategic vendorsSupervises functional area staff and oversees day-to-day functional area operational activities and work product including but not limited to maintenance of functional area databases; reporting requests; contract, network and credentialing updates; communications and outreach; service desk requestsAudits internal files or systems to identify non-compliance and oversees resolution of issues foundOversees quality reviews of the databases (e.g. contracting, credentialing, NCRx) and functional area reports to ensure data integrity and completenessMonitors and extracts data from federal and/or state databases to support functional area workRepresents functional area for external regulatory audits and financial auditsSupports compliance with URAC, Government entities and Navitus’ policy and procedures to ensure applicable quality, regulatory and organizational standards are metCreates and generates functional area reports (e.g. credentialing, performance guarantees, department metrics) and submits to appropriate leadership and committees in a timely and accurate mannerOther duties as assigned Qualifications

What our team expects from you?

College or 2-year Technical Degree or equivalent experience is preferredCPhT preferred2-5 years business-setting experienceRetail pharmacy experience or experience in a managed care pharmacy setting desiredPrior experience analyzing medical and/or pharmacy claims or credentials are highly desiredIdeal candidate will be able to work independently, have telephonic and written communication skills, data-mine variable databases, analytical skills and have the ability to manage multiple prioritiesCandidate must be proficient in Microsoft applicationsCandidate must rely on knowledge of Navitus’ business concepts, practices, and policies and procedures to accomplish goalsParticipate in, adhere to, and support compliance program objectivesThe 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

 

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