Job Opening: Product Manager Coordination of
- Company
- NAVITUS HEALTH SOLUTIONS LLC
- Location
- APPLETON, WI
- Posted on
- May 21, 2024
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. 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 Product
Manager, Coordination of Benefits is responsible for the development,
administration, maintenance, and oversight of the COB Program. The
Product Manager will ensure that the appropriate software, processes,
procedures, and oversight monitoring are implemented and operational to
meet changing COB program needs. The Product Manager, Coordination of
Benefits will work closely with members of the following departments:
Analytics, Benefit Systems, Claims Adjudication Development, Client
Services, Compliance, Data Services, Government Programs,
Implementation, and Member Service, ensuring COB is administered and
maintained according to industry, state, federal, Medicare, Medicaid,
and Exchange regulations. Is this you? Find out more below! How do I
make an impact on my team? Manages coordination of benefits (COB)
day-to-day work: Coordinates and monitors third party liability (TPL),
other health insurance (OHI) files process and loads Ensures accurate
and timely reporting Ensures turnaround times and performance guarantees
are met As needed, initiates calls to other insurance
carriers/pharmacies to gather coordination of benefits data and pursue
COB recoveries (pay and chase) Serves as the subject matter expert for
COB program questions, COB system enhancements and build, COB RFP
questions and new client implementations involving COB Remains current
with changing regulatory and industry COB requirements, ensuring the
Navitus COB program remains compliant Leads and participates in
applicable NCPDP COB task groups Meets with key personnel in other
departments to understand COB needs, makes recommendations and leads the
implementations of solutions to meet customer and program needs
Regularly audits and tests COB operational processes to ensure end to
end integrity Creates and maintains COB policies, procedures, workflow,
and training What our team expects from you? College degree or
equivalent experience required in managed care or health insurance
Minimum of five years\' experience with Medicare, Medicaid and
Commercial claims processing, COB and third-party recoveries in an
automated claims environment... 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/F925003A919E4066