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 Supervisor, Technical Operations is responsible for leading Technical Operations team members. This individual will interact with key operating departments related to Technical Operations business development and operational compliance and understands the roles and responsibilities of the business area and how it fits within the entire corporation. The Supervisor, Technical Operations proactively reviews and develops an understanding of Government Programs regulations and related CMS and/or specific state guidance.

The Supervisor, Technical Operations assists in the review and analysis of special projects and may lead these projects as necessary, including help develop and execute test scenarios/plans, and coordinate user/system testing. The Supervisor, Technical Operations will be proficient at data reporting and analysis using the standard tools for reporting at Navitus.

Is this you? Find out more below!

How do I make an impact on my team?

• Leads a team responsible for monitoring compliance with regulatory requirements.
• Understands Government Programs Technical Operations, with emphasis on processes assigned to the Supervisor’s team. This includes being the process subject matter expert and performing functions to support Government Programs processes and translating them into documented process steps.
• As Process Owner, leads the Quality Oversight Meetings to ensure process compliance and reliability for all assigned processes. Is a self-directed leader ensuring appropriate action is taken for process defects, non-compliance, and/or inefficiencies for assigned processes.
• Ensures technical processes supporting government programs have the appropriate controls, oversight and reporting on the end-to-end process. If process controls are absent, the expectation is to identify, define, and implement new ones as needed.
• Develops and maintains clear and concise documentation for all assigned processes using proficient Technical Writing skills. Maintains process support documentation that other stakeholders may utilize to understand the complex processes performed by the team.
• Establishes processes that are scalable and efficient and ensures smooth transition to operational maintenance by the Technical Operations Staff. Identifies key metrics to monitor the compliance and accuracy of the process establishing oversight methods that are operationally efficient and effective. Provide SME assistance when process metrics indicate possible risk to compliance or accuracy and lead any corrective action.
• Seeks opportunities to initiate and manage projects to improve existing processes delivering enhanced quality and efficiency. Assists in review and analysis of special projects and may lead these projects as necessary.
• Reviews and develop a working knowledge of all new and existing client plan designs.
• Develops a solid working knowledge of Navitus’ Government Programs claims processing software.
• Identifies issues in the Government Programs Department and propose solutions that resolve the immediate need and prevent reoccurrence of the issue.

What our team expects from you?

• B.S. degree in Computer Science, Financial Recoveries, Healthcare Insurance, management, business, statistics or related field or equivalent experience.
• Two+ years supervisory experience preferred. Knowledge or experience in insurance processes and/or government programs such as Medicare or Medicaid will be an advantage.
• 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, Appleton WI Office
• 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, College Savings Plan, Paid Parental Leave, Adoption Assistance Program, and Employee Assistance Program