Job Information
NAVITUS HEALTH SOLUTIONS LLC Medicare Policy Oversight Analyst in APPLETON, Wisconsin
JOB REQUIREMENTS: 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 Medicare Policy Oversight Analyst to our Government Programs 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 Policy Oversight Analyst (POA) is responsible for oversight of all Medicare Part D policies to ensure consistency in content and level of detail required to demonstrate compliance for all Medicare requirements to external auditors/clients. The POA collaborates with staff across the organization to ensure policies meet the goal of documenting each requirement and how we meet each requirement. The POA will propose suggestions to improve the effects of existing policies and assist in the draft and finalization of new policies that are required to support new/changing Medicare guidance. The POA maintains a policy crosswalk to all relevant guidance and responds to audits related to policy submission. Is this you? Find out more below! How do I make an impact on my team? Ensures all Medicare policies are written at a level that demonstrates both Compliance with Medicare requirements including the proper (and most current) guidance citations. The appropriate level of detail that demonstrates how Navitus meets each requirement. Facilitate responses to audits that require policy submission. Proposes suggested updates and collaborates with policy owner to ensure updates are made timely. Develops, implements and maintains a policy crosswalk/documentation system that maps each Medicare requirement to Navitus policies. Develops and maintains deep subject matter expertise related to Medicare Part D requirements. Updates policy crosswalk and collaborates with policy owners to update policies in a timely manner when guidance is new/updated. Reviews drafts of new policies Develops and tracks a schedule of policy validation and ensures the processes documented in our policies are followed. Acts as a resource to the functional area in policy development for Med D What our team expects from you? College degree or a minimum of three years of relevant health plan, compliance, CMS and/or legal experience. Knowledge of Medicare Part D requirements required. Technical or legal reading and writing experience... For full info follow application link. Navitus Health Solutions is an Equal Opportunity Employer: Disabled/Veterans/Male/Female/Minority/Other ***** APPLICATION INSTRUCTIONS: Apply Online: ipc.us/t/FF66113CAE764C97