Microsoft 365

Recruitment

• Create job requisitions in the Applicant Tracking System and post to outside job boards
• Coordinate and execute interview scheduling and calendar management for candidate interviews
• Maintain flow of communication between interviewing candidates, Talent Acquisition Partners and hiring managers
• Provide recruitment interviewing support as directed
• Communicate with and provide support to hiring managers and applicants on open positions as needed/directed
• Conduct pre-employment background checks/drug screens through 3rd party vendor
• Ensure accurate employee record keeping by utilizing a New Hire Checklist and collecting all needed documents
• Process electronic verification of eligibility to work in the United States (eI-9)
• Process Employee Referrals
• Assist in pre-onboarding and new hire file maintenance
• Update and maintain the job description database
• Assist in distributions and employee events; and engage in regular participation with the HR culture enhancement programs as assigned
• Assist with preparation and maintenance of related HR Policies/procedures, audit materials, employee communications and job descriptions
• Assist with special projects for organization-wide HR programs

Coordinator, Talent Acquisition – Future Talent

Compliance

• Maintain audit readiness for SOC 2 Type II, HIPAA, and NCQA by coordinating evidence collection, tracking controls, and preparing documentation.
• Conduct and support internal audits, risk assessments, and remediation planning to close identified compliance gaps.
• Draft, review, and update compliance policies and procedures; ensure alignment with HIPAA Privacy & Security Rules and SOC 2 control requirements.
• Monitor compliance dashboards, audit logs, and control evidence to ensure timely execution of control activities.
• Partner with external auditors, regulators, and accreditation bodies during reviews, providing required documentation and responses.
• Support vendor due diligence and Business Associate Agreement (BAA) compliance reviews; maintain third-party risk documentation.
• Collaborate with IT Security to ensure identity/access controls, endpoint protections, and data governance align with HIPAA and SOC 2.
• Track regulatory changes (HIPAA, HITECH, NCQA, state/federal healthcare regulations) and assess organizational impact.
• Deliver compliance training and awareness programs for employees, contractors, and vendors.
• Support incident response activities, including investigation, documentation, and reporting of potential PHI breaches or compliance events.
• Partner with stakeholders to gather requirements for compliance-driven initiatives (e.g., secure data integrations, PHI workflows, audit reporting).
• Document processes, workflows, and use cases that demonstrate compliance alignment for IT and operational teams.
• Translate compliance obligations into system requirements and specifications for IT/security implementation.
• Participate in UAT (User Acceptance Testing) and system validation to ensure compliance-related requirements are met.
• Develop compliance-related reporting dashboards (e.g., audit status, control evidence, incident tracking).
• Maintain knowledge base documentation, SOPs, and internal IT training resources.
• Participate in change management, incident response, and problem management processes in alignment with Compliance best practices.
• Participate in, adhere to and support compliance and diversity, equity, and inclusion program objectives.
• Other duties as assigned.

Analyst, Healthcare Compliance

Operations

• Responsible for strategic and tactical execution and management of claims, contact center and various other operations
• Manage Operations team(s), including supervision of managers and supervisors
• Oversee financial outcomes, including claims loading, adjudication, and payments
• Manage all aspects of operations and ensure efficiency; develop and implement strategic plans aligned with company objectives
• Meet financial and performance goals, including budget preparation
• Provide vision for call center goals and lead a multi-site team; foster a collaborative, employee-focused environment; provide ongoing formal training
• Conduct data analysis and present insights; establish and monitor key performance indicators (KPIs); implement best practices and drive process improvements for scalability and efficiency
• Manage cross-functional projects; collaborate with clinical, IT, and other departments; own pharmacy and vendor relationships for claims processing, call routing, reporting, and communication
• Vendor and client-facing responsibilities as needed; support corporate initiatives
• Oversee call center operations, ensuring service quality and adherence to metrics; implement strategies for customer loyalty and consistency in messaging

Operations Director, SPBM

Customer Support

• Serve as primary support source for a specific client’s member services
• Front-line call taking to understand and improve customer experience
• Answer questions, resolve issues, and provide guidance to members
• Track all client patients and proactively reach out to ensure medication delivery
• Receive, analyze, and approve PA override requests using internal resources
• Handle Jira tickets according to service level agreements and enter process issues
• Follow established procedures for production, productivity, quality, and customer service
• Meet performance targets for speed, efficiency, and quality
• Communicate constantly with members about positive or negative experiences
• Use daily reports and ticket processes to identify and mitigate member issues
• Trend training needs and identify/implement improvement opportunities
• Act as liaison between customer and Archimedes and understand impact on fiscal stability

Senior Client Support Representative

Procurement

• Execute daily purchasing tasks including order placement, tracking and inventory management.
• Maintain and develop as needed, accurate and up-to-date records of all purchasing transactions (trackers / dashboards).
• Reconcile invoices against inventory receipt to identify and resolve shortages or overages within an order.
• Reconciliation of purchase orders entered into inventory management system against invoices to ensure accurate pricing is reflected.
• Monitor primary and secondary vendor agreements for compliance with generic compliance and minimum volume commitments.
• Ensure / communicate timely availability of inventory to meet operations team requirements.
• Develop and manage relationships with key suppliers.
• Utilize data analytics to identify opportunities for cost savings and process improvements.
• Continuously evaluate and refine procurement strategies to meet changing business needs and market conditions.
• Track pull through and ensure alignment between inventory levels and sales forecasts.
• Analyze market trends to inform purchasing decisions and anticipate potential supply chain disruptions.
• Monitor supplier performance and market conditions to identify risks and opportunities.
• Contribute to the department goal of improved efficiency and effectiveness, including the capture of strategic client opportunities using approved reference resources that support proposal and presentation development activities.
• Other duties as assigned.

Inventory and Procurement Specialist

Executive Assistant

• Support the CPO with schedules, telephone, email, filing and document organization, meeting preparation and follow up
• Prepare presentations, presentation slides and documents, and presentation support materials
• Maintain positive communications and rapport throughout the organization
• Assist the CPO in ensuring enterprise-wide adherence to policies, procedures, compliance regulations, and other processes
• Assist all management and employees as a resource in areas of responsibility
• Organize and maintain a central corporate repository of documents and files
• Deal with multiple tasks daily, including prioritization and successful execution/resolution
• Prepare agenda and compile minutes as required for leadership meetings
• Conduct projects and participate in team activities to identify problems and improve work processes and systems
• Other duties as assigned

Senior Executive Assistant, Corporate

Project Manager

Navitus Health Solutions is seeking a Client Operations Project Coordinator to join our team!
The Operations Coordinator is responsible for updates that effect both internal and external parties, including managing timelines, monitoring
The Operations Coordinator is a highly motivated professional with at least 3 years successful PBM or health care experience and solid knowledge of Microsoft Excel, Word, PowerPoint, and SharePoint.
Experience with CRM, Smartsheet, NCRx, 3D and various reporting tools are a plus.
Ability to analyze and interpret data is required.
Ability to plan, organize and focus on details is critical.
The Operations Coordinator must have strong relationship skills to be able to interact with key operating departments related to benefit changes, business development and operational activity.
Excellent communication skills are necessary to ensure all team members are kept well informed of the process.
Support all internal and external department projects, deliverables, and program assistance
Facilitate project-based meetings, outreach, and various communications for the team
Ensure all requirements are documented in standard project templates and tools while maintaining key deliverables
Act as an intermediary and provide support between departments to ensure consistency and efficiency of project assignments
Lead all benefit and plan changes in collaboration with internal and external partners to ensure accurate and timely completion
Facilitate all third-party transitions, client terminations, broker of record updates, admin fee updates and other miscellaneous internal projects as assigned
Create and maintain project plans and meeting minutes for project monitoring purposes
Continuously monitor progress in terms of the status of the project and report back to internal management and subject matter experts using weekly status reporting formats
Provide go-live support either through remote access or internal on-site access. This may require working on January 1st of each year and other non-business days as needed
Other duties as assigned

Project Coordinator, Client Operations

Program Manager

Manage, plan, direct, advise and oversee all activities related to certification
Support, and when directed, lead FFS day-to-day operational activities
Coordinate with the FFS Implementation Manager to ensure the effective coordination of all Company resources to fulfil FFS contracted commitments
Continually monitor accepted FFS’ CMS certification and program performance indicators that ensure established goals and deadlines are met
Support the creation and presentation of data for strategic business planning, including development of new business initiatives, budgets, resource demands, and operating execution
Support the delivery of on-going formal training to team members
When applicable, facilitate the hiring process, on-boarding process, mentoring and termination process for client/account team members as well as Business Analysts assigned to expanding functional requirements in the market
Oversee policy and procedure administration; ensure regulatory and contractual compliance including individual contract service-level agreements
Other duties as assigned

Program Manager, Medicaid Certification and Compliance

Account Manager

• Lead the Clinical Account team and direct vision, strategy, and design of clinical product and service offerings for PBM clients
• Oversee utilization management, population health, specialty pharmacy, and clinical support of Medicare and Medicaid programs
• Direct operational, financial, compliance and contractual aspects of Clinical Account Management
• Provide leadership, direction, and skill development to team members
• Participate in proposal review, client and prospect meetings, and Client Advisory Group programming
• Partner with account management, implementation, and analytics to maintain client satisfaction and retention
• Represent Navitus at industry events and publications to support business development
• Establish departmental strategy, manage budgets, and ensure operational efficiency

Senior Director, Clinical Account Management – PBM Clients

Account Executive

• Attends and leads client meetings and actively participates as necessary
• Develop and implement a clinical plan that meets the goals and objectives of the client and is in alignment with corporate business strategy
• Analyze client’s financial and utilization data to identify opportunities for improving health care and/or controlling drug and overall health care costs
• Recommend and oversee implementation of select clinical programs
• Actively participate in developing the clinical strategy for client
• Consultant on Plan/Benefit design recommendations
• Participate in development and delivery of annual reviews to client
• Consultant for formulary management and administration
• Provide ongoing evaluation of clinical programs and services
• Other duties as assigned

Clinical Account Executive, RPh

Product Manager

• Manage the assigned products through adjusting and optimizing the marketing mix as the products move through the product life cycle
• Apply clinical knowledge in the development of member and client services for high-cost specialty drugs
• Maintain specialty pharmacy pipeline and identify opportunities where assigned products would be a good fit
• Assist in the analysis of product capacity and capabilities for managing new clients
• Collaborate on the development of related products in a way designed to foster teamwork and maintain an outstanding customer service culture, including internal customers
• Serve as a specialty pharmacy and specialty drug subject matter expert to client and clinical teams, marketing, and external parties
• Develop a keen understanding of the assigned business unit products in the marketplace in order to work collaboratively to expand product offerings, refine current product positioning and develop key messages for both existing and potential clients
• Monitor the products performance, position and utility for our clients and partners and provide strategized product enhancements within the evolving market
• Continually monitor and evaluate the specialty pharmacy landscape to ensure effectiveness of program
• Apply project management techniques to effectively manage project scope, resources, and timeline for product development initiatives
• Work with Account Management and Sales to better understand product performance, measure product KPI’s and recommend potential improvements
• Execute departmental strategic initiatives in support of the corporate strategic plan
• Analyze market data and provide new product ideas or enhancements to current products which will meet market needs
• Assure appropriate testing has been conducted for any system/app enhancement or break-fix
• Ability to work effectively in a culturally diverse work group
• Ensure products meet all regulatory requirements

Clinical Product Manager, RPh

Business Analyst

• Navitus is a company focusing on pharmacy benefits management; Navitus - Putting People First in Pharmacy - Navitus was founded as an alternative to traditional PBM models. Our Business Analyst provides business analysis support for development, implementation, and maintenance of all products within the Technical Operations Department. The Business Analyst interacts with key operating departments related to Technical Operations business development and operational compliance. This individual develops an understanding of Government Programs regulations and related CMS and/or state-specific guidance, and is responsible for proactive review of all CMS and/or state regulations and guidance. The Business Analyst helps develop and execute test scenarios/plans, coordinates the user/system testing, and may be responsible for quality assurance. The Business Analyst is proficient in data reporting and data manipulation for analysis, as well as using standard tools for reporting at Navitus. These tools include, but are not limited to, Microsoft Excel and QlikView.

Business Analyst, Government Programs

Full-stack Engineer

• The Sr. Software Developer ensures efforts are in alignment with the Information Technology team to support customer-focused objectives and the IT Vision, a collaborative partner delivering innovative ideas, solutions, and services to simplify people’s lives
• The idea candidate will have 3-5 years of experience working as a Microsoft C# developer with 2-3 years in an AWS environment with a solid understanding of eventing patterns
• This candidate will have worked with a primary focus in backend deliverables such as API development and ETL processes
• The Sr. Software Developer’s role is to define, design, develop, test, analyze, and maintain new and existing applications in support of the achievement of business requirements
• This includes designing, documenting, coding, testing, and analyzing software programs and applications
• The Sr. Software Developer will also research, design, document, and modify software specifications throughout the production life cycle
• Responsibilities: Assist in defining software development project plans, including scoping, scheduling, and implementation
• Consistently design, write, translate, and code software programs and applications according to specifications
• Write new and modify existing programming scripts to enhance functionality and/or performance of company applications as necessary
• Design, run and monitor software performance tests on new and existing programs for the purposes of correcting errors, isolating areas for improvement, and general debugging
• Administer critical analysis of test results and deliver solutions to problem areas
• Generate statistics and write reports for management and/or team members on the status of the programming process
• Conduct research on emerging application development software products, languages, and standards in support of procurement and development efforts
• Code reviews and mentoring of less experienced development staff on an as needed basis to ensure conformity to company standard practices
• Train end users to operate new or modified programs
• Other Responsibilities (including one or more of the following): Unix/Linux shell scripting, Informatica/Talend, C# and .NET platform, React., AWS Cloud Development, Oracle, Telerik, MS SQL, Visual Studio/Team Foundation Studio
• Other duties as assigned

Senior Software Developer, AWS

Manager

The Manager, Contracts & Billing acts as a lead for general accounting functions with emphasis on month-end close, financial reporting and analysis.
Represents Accounting & Billing during assigned client implementations and partners with Implementation, Sales and Account Management to translate RFPs and client billing requirements into capital needs or FTE resources.
Assists in client implementation project planning, communicates billing and finance risks, and supervises rebate accounting and disbursement function.
Collaborates on Finance Transformation and process improvements; participates in capital project planning, variance analysis and provides information to FP&A for forecasting and budgeting models.
Serves as functional Billing and Accounting expert, mentors finance staff, and participates in compliance and DEI initiatives.

Manager, Contracts and Billing

• Develop and deliver clinical messages to physicians, members, clients, and consultants
• Manage formulary strategy and clinical policy development
• Clinical program development including both medical and pharmacy benefit management
• Define, document, and deliver results for plan sponsors
• Evaluate and summarize clinical literature as well as financial implications related to medication management options
• Ability to present deep clinical and cost effectiveness information as a peer-to-peer consult