This role leads the team that keeps pharmacy benefits configured correctly and moving on time. If you can manage people, run workflow like a machine, and balance customer service with operational discipline, you’ll help protect performance guarantees and make sure members get the benefits they’re supposed to get.
About Navitus
Navitus Health Solutions is a pharmacy benefits organization built as an alternative to traditional PBM models, focused on making medications more affordable by removing cost from the drug supply chain. Their culture emphasizes diversity, creativity, growth, and strong service to customers and internal teams.
Schedule
Full-time remote role
Monday–Friday, 8am–5pm
Remote eligibility excludes residents of: AK, HI, ME, MS, NH, NM, ND, RI, SC, SD, WV, WY
What You’ll Do
- Oversee Claim Adjudication Operations (CAO) roles to support accurate, timely configuration and data transfers for client hierarchy, benefits, and networks
- Deliver high-touch, customer-centric service through strong collaboration and communication with internal and external partners
- Partner with CAO customers and stakeholders on day-to-day work and contribute to action plan creation
- Run and manage Kanban boards and daily huddles, including sizing and prioritizing work requests
- Ensure turnaround times and performance guarantees are met through tight workflow oversight
- Assign resources for daily work, audits, root cause analysis, and corrective action plans (CAP)
- Conduct 1:1s to gather feedback, mentor associates, support career development, address performance, and provide workload/project guidance
- Handle workforce management for direct reports, including overtime needs, time off, and time tracking
- Use strong soft skills and negotiation to work across departments and personalities, adjusting communication style to the audience
- Align team objectives with division and company strategic initiatives
- Support compliance and DEI program objectives
What You Need
- Bachelor’s degree or equivalent work experience
- 4+ years of relevant experience
- Knowledge of one or more responsibilities listed above (strongly preferred)
- PBM industry experience (preferred)
- Knowledge of data privacy practices/laws (preferred)
- Healthcare experience and HIPAA familiarity (a plus)
- Experience working on multi-disciplinary teams (a plus)
- Understanding of HR management principles and practices (a plus)
- Ability to collaborate respectfully and support compliance objectives
Benefits
- Health, Dental, and Vision insurance
- 20 days paid time off
- 4 weeks paid parental leave
- 9 paid holidays
- 401(k) match 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)
Pay Range: $61,968 – $74,660/yr (plus 7.5% at-risk bonus eligibility).
This is a “people + process + accountability” role. If you’ve led teams in ops, claims, or configuration work and you like running tight systems, it’s worth a serious look.
Happy Hunting,
~Two Chicks…