Senior Manager, Quality Assurance, Benefit Configuration

Navitus Health Solutions

Sr. Manager leading Quality Assurance function focused on benefit configuration verification at Navitus.

Posted 6/10/2026full-timeRemote • Alaska, Hawaii, Maine, Mississippi, New Hampshire, New Mexico, North Dakota, Rhode Island, South Carolina, South Dakota, Virginia, West Virginia, Wyoming • 🇺🇸 United StatesSenior💰 $108,429 - $135,536 per yearWebsite

About the role

Key responsibilities & impact

Lead and oversee a team of Quality Assurance Analysts, ensuring effective execution of benefit configuration testing, validation, and audit activities.
Ensure accurate and timely completion of complex quality assurance for new client implementations, benefit changes, and ongoing maintenance across all lines of business.
Establish and enforce quality assurance standards, procedures, and audit methodologies, ensuring compliance with internal requirements.
Provide oversight on root cause analysis, issue resolution, and corrective action planning, ensuring issues are identified, tracked, and resolved effectively by partnering with Issue Management Team.
Collaborate cross-functionally to drive process improvement, automation, and scalable initiatives to enhance efficiency, reduce risk, and improve testing outcomes.
Oversee development and maintenance of training materials, job aids, and standard operating procedures, ensuring consistency across the team.
Support and lead client interactions, including presentations, audits, implementations, and RFP responses related to quality assurance practices.
Ensure effective use of workflow management, issue tracking, and reporting tools to support visibility, accountability, and performance tracking.
Lead and inspire high-performing teams by providing strategic direction, aligning talent and resources with organizational goals, and driving operational excellence across key initiatives.
Other duties as assigned.

Requirements

What you’ll need

Bachelor's degree or equivalent work experience required.
6+ years of relevant work experience in the healthcare industry in benefit confirmation, operations, or quality assurance required.
PBM experience preferred.
5+ years of experience leadership in PBM, healthcare operations, or similar industry required.
4+ years of work experience using MS Excel filtering, sorting, and analyzing data with ability to write complex formulas required.
Strong PBM Quality Assurance validation and testing knowledge preferred.
Knowledge of government programs such as Medicare or Medicaid, network pricing, and formulary required.
Participate in, adhere to, and support compliance program objectives.
The ability to consistently interact cooperatively and respectfully with other employees.

Benefits

Comp & perks

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!

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

quality assurancebenefit configuration testingroot cause analysisissue resolutiondata analysisMS Excelcomplex formulasprocess improvementaudit methodologiesautomation

Soft Skills

leadershipcollaborationcommunicationstrategic directionteam inspirationoperational excellenceclient interactionproblem-solvingaccountabilitytraining development