Navitus Health Solutions is seeking a Medicaid Product Manager to join our Government Programs department!
The Medicaid Product Manager (MPM) will be responsible for providing regulatory support for the Navitus Medicaid program. The Product Manager (MPM) will facilitate efforts to develop and implement various Medicaid process changes according to the requirements defined by the Center for Medicare and Medicaid Services (CMS) and each State regulating entity. The MPM is responsible for reviewing and acting upon all CMS and State guidance related to these functions, including technical guidance as well as business process-related guidance. The MPM must work closely with all key functional areas that administer certain Medicaid functions, including but not limited to Implementation, Formulary Administration, Provider Services, Clinical and Client Services departments.
Is this you? Find out more below!
ResponsibilitiesHow do I make an impact on my team?
Develops and maintains deep subject matter expertise related to CMS and State Medicaid requirements for provider materials, formulary/PDL, coverage determinations, grievances and appeals, customer care and pharmacy helpdesk, third party liability, 340B, and reportingFacilitates and oversees the implementation and maintenance of Medicaid functional processes for all Managed Medicaid clientsMonitors CMS and State regulations, guidance, and system changesResponsible for operational oversight of the Navitus Managed Medicaid product line. Provides direct functional support for required reporting and provider/member materialsProvides product support for client implementationsSupports compliance efforts including State, CMS audits and client delegation auditsSupports the development of maintenance of product documentation, including training materialsAssists the Program Manager in reviewing and managing updates to State contracts, ensuring content is in line with agreed upon services and regulationsDevelop and continually evaluate Government Program Operations functions, while monitoring work product measure/targets including turn-around times and accuracyOther duties as assigned QualificationsWhat our team expects from you?
A minimum of a bachelor’s degree or equivalent work experience is requiredExperience and expertise in product management, project management and business analysis with a “track record” of tangible success, including team collaboration/relationship-building/management in health care or related environment is essentialAdditional background in business or healthcare administration is desiredTwo to five years of relevant experience in administering health insurance programs strongly desiredWorking knowledge of Medicaid regulations, standards, and processes a plusParticipate in, adhere to, and support compliance program objectivesThe ability to consistently interact cooperatively and respectfully with other employeesWhat can you expect from Navitus?
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!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.
#LI-Remote
Options ApplyApplySubmit a ReferralRefer Sorry the Share function is not working properly at this moment. Please refresh the page and try again later. Application FAQsSoftware Powered by iCIMS
www.icims.com