• Job Description

  Req#: 2674
  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 $112,640.00 - USD $140,800.00 /Yr.
  
  Work Schedule Description (e.g. M-F 8am to 5pm)
  
  M-F 8am-5pm, CST
  
  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 Systems and Quality Analyst Manager to our team.
  
  The Systems and Quality Analyst Manager will provide support for the development, implementation, and maintenance of our FFS Medicaid products. The FFS implementations require full compliance to NCPDP standards, CMS and State regulations and with defined business rules and policies. The Systems and Quality Analyst Manager will be responsible for managing the activities during the DDI and the life of the contract to ensure the system meets all requirements set forth.
  
  Is this you? Find out more below!
  
  Responsibilities
  
  How do I make an impact on my team?
  
  • Develop and maintain deep knowledge of NCPDP pharmacy POS claims processing, Federal and Supplemental Rebates and Analytics Standards.
  • Develop an understanding of unique attributes within a claim transaction where contracted State governments apply specific regulatory requirements to support their programs.
  • Strong understanding of software development lifecycle (SDLC), testing methodologies (e.g., Agile, Waterfall), and QA tools (e.g., test management, automation frameworks). Understand the competitive landscape, regulatory lifecycle and related government processes surrounding FFS.
  • Develop and implement comprehensive QA strategies, plans, and procedures. Understands industry standards, best practices, and emerging trends in quality assurance.
  • Define quality standards and ensure adherence throughout the product development lifecycle.
  • Oversee the execution of testing activities, including functional, system, regression, and performance testing.
  • Collaborate with product managers, developers, and other stakeholders to integrate quality into the product development process.
  • Communicate quality-related information to various teams and management.
  • Monitor key quality metrics and identify areas for improvement. Analyze test results and defect data to identify trends and root causes. Conduct audits and inspections to ensure compliance with quality standards.
  • Work with the project management office to utilize and enhance tools that support the requirements, development, and testing processes.
  • Implement and maintain test automation strategies to improve efficiency and coverage.
  • Collaborate with the training/development staff to deliver and update training documentation.
  • Create and update status reports upon request that communicate the health of the products.
  • Perform quality analysis on all aspects of claims, rebates, portal etc. and document findings and work with IT to remediate any issues.
  • Participate in, adhere to and support compliance and diversity, equity, and inclusion program objectives.
  • Other duties as assigned.
  
  
  Qualifications
  
  What our team expects from you?
  
  
  • Education: Bachelor's degree or equivalent work experience required.
  • Certification/Licenses: Relevant certifications from recognized industry organizations preferred. Business Analysis Certification (PMI, IIBA) or College level program preferred.
  • Experience:
  • • 4 years of Claims Processing systems and QA Manager experience for a healthcare company required.
    • Elicitation and documentation of Medicaid Business requirements required.
    • QA of the implementation of government regulations into software development activities required.
    • Participating in an agile development project team required.
    • Experience with core software applications, including Microsoft Word and Excel required.
    • Knowledge of Software Development Lifecycle (SDLC) methodologies of client organizations required.
    • Experience in roles like a Business Analyst, Business Systems Analyst, or Product Manager preferred.
    • Experience with Microsoft Visio, PowerPoint, Project and Team Foundation Server (TFS) preferred.
    • 3 years' experience in large scale system implementation projects preferred.
    • Healthcare industry business practices and HIPAA knowledge preferred.
    • Experience with pharmacy benefits and claims processing preferred.
    • Experience in mockups, wireframing and prototyping UI with UX principles preferred.
    • Experience with multiple testing methodologies, including automation preferred.
  
  
  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!
  
  We are 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.
  
  #LI-Remote
  
  Location : Address
  
  Remote
  
  Location : Country
  
  US

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