Analyst, Tech Operations – Government Programs

This is a fully remote position, open to applicants in Idaho.

📋 Description

• Responsibilities may encompass one or more of the following: administration and oversight of Employer Group Waiver Plan (EGWP) enrollment, Retro-eligibility processes, Financial Information Reporting (FIR), Plan Finder Submission, Coordination of Benefits (COB), Reject Management, management and reconciliation of Prescription Drug Event (PDE) errors, Medicaid Encounter Data, Affordable Care Act (ACA) Claims Submission, Explanation of Benefits (EOB), Retiree Drug Subsidy (RDS), and Claim Auditing.

• Supervise the timelines for the assigned processes, making adjustments as necessary to ensure that deadlines are met, and notify management when schedules are at risk.

• Ensure that process documentation accurately reflects the current procedures and make updates as required.

• Assist subject matter experts (SME) in defining and documenting the steps of processes, offering input on the requirements for technical specifications.

• Review and investigate errors, prioritizing reconciliation efforts in line with State and Federal guidelines.

• Communicate effectively with Employer Groups, Clients, State/Federal Agencies, external vendors, and internal departments at Navitus to address action items, resolve issues, and manage expectations to ensure timely and accurate resolutions.

• May be required to work outside of regular business hours to complete time-sensitive processes as needed.

• Additional duties as assigned.

⛳️ Requirements

• Bachelor’s or Associate Degree in a business-related field; or an equivalent of an associate degree along with 2 years of work experience, or 4 years of work experience and a high school diploma or equivalent.

• At least 1 year of relevant work experience.

• Experience in pharmaceutical claims adjudication systems, retail pharmacy, or within a health plan organization is preferred.

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

• Ability to consistently interact cooperatively and respectfully with fellow employees.

🏝️ Benefits

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

• 20 days of paid time off.

• 4 weeks of paid parental leave.

• 9 paid holidays.

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

• Adoption Assistance Program.

• Flexible Spending Account.

• Educational Assistance Plan and support for Professional Memberships.

• Referral Bonus Program offering up to $750!