Advisor, Industry Standards

This is a fully remote position, open to applicants in Alaska, +13 more states.

📋 Description

• Participate in NCPDP Task Groups and Work Groups to represent Navitus’ viewpoint on proposed new standards and modifications to existing standards.

• Interact directly with clients and auditors as a subject matter expert and strategic consultant.

• Build industry networking relationships to collaborate on NCPDP standards and processes.

• Summarize relevant NCPDP standards and convey impacts to Navitus leadership and departments.

• Provide subject matter expertise for functional and business requirements for the claims adjudication platform.

• Research issues, collaborate with both internal and external customers to resolve them, and oversee corrective measures.

• Develop a comprehensive understanding of claims adjudication system capabilities and limitations.

• Review changes in prescription benefit standards and convert them into business and system requirements.

• Facilitate pharmacy testing for NCPDP compliance, including the creation of test plans and updates to payer sheets.

• Perform additional duties as assigned.

⛳️ Requirements

• A minimum of 2 years of work experience in PBM Operations is required.

• Membership in NCPDP and expertise in standards with active participation in NCPDP work groups and task groups is preferred.

• Previous experience in the PBM industry is required.

• Experience in reviewing and interpreting complex regulatory guidance is necessary.

• Participate in, adhere to, and support the objectives of the compliance program.

• Ability to consistently interact cooperatively and respectfully with colleagues.

🏝️ Benefits

• Comprehensive benefits package for Health, Dental, and Vision insurance.

• 20 days of paid time off.

• 4 weeks of paid parental leave.

• 9 paid holidays.

• 401K company match of up to 5% with no vesting requirement.

• Adoption Assistance Program.

• Flexible Spending Account.

• Educational Assistance Plan and Professional Membership assistance.

• Referral Bonus Program – up to $750!