Job Description

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. Due to growth, we are adding this Analyst, Quality Control to our Claims Adjudication Operations, Support Department. 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. The Quality Control Analyst (QCA) is responsible for supporting and coordinating quality control analysis and related processes for activities performed by Navitus Health Solutions. The QCA is responsible for engaging in preventive and detective quality controls that can be measured quantitatively and qualitatively to validate Navitus processes. The QCA will work with oversight and moderate independence to ensure quality control validations are completed in a timely manner. This individual requires an intermediate understanding of quality controls and how to apply such controls to department processes. The QCA shall have the ability to learn critical department processes with operational relevance and gain reasonable understanding for effective monitoring. The QCA shall assess assigned processes lifecycles, improvements, or enhancements and seek supervisory guidance where appropriate. Is this you? Find out more below! How do I make an impact on my team?

• Performs quality control/check tasks timely
• Reports gaps or deficiency in performance of quality control/check
• Follows policies and procedures including departmental and quality policies set by the organization
• Reports and informs on quality control/check outcomes
• Alerts leaders to systemic issues affecting outcome of quality control/check
• Assist with preparation of all required quality control/check tasks
• Maintain organized documentation to demonstrate performance of quality control/check standards.
• Make process improvement recommendations
• Evaluate if quality control/check processes are meeting standards and expectations
• Assist in planning quality controls and/or checks

• College or 2-year Technical Degree or is preferred but not required. Equivalent experience will be considered in lieu of degree.
• Two years experience in a PBM or health plan preferred
• Experience in quality control, performance or audit preferred
• Knowledge of quality principles, standards and processes strongly desired
• Intermediate to expert knowledge in MS Office including Word, Excel, Visio and PowerPoint preferred
• Participate in, adhere to, and support compliance program objectives
• The ability to consistently interact cooperatively and respectfully with other employees

• Hours/Location: Monday-Friday 8:00am-4:30pm, CST-Remote
• Paid Volunteer Hours
• Educational Assistance Plan and Professional Membership assistance
• Referral Bonus Program \xe2\x80\x93 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