Network Configuration Analyst III (Remote)

Navitus Health Solutions; United States; On-site; USD 54,000 - 65,000; Full time

Benefits offered by this job

Health, Dental & Vision insurance

PTO 20 days

Parental leave 4 weeks

9 paid holidays

401K company match

Adoption Assistance

Flexible Spending Account

Educational & Membership assistance

Referral Bonus – up to $750

Job summary

Navitus Health Solutions is seeking an Analyst III, Network Configuration to join our team. You will configure pharmacy networks in the adjudication system and work with multiple Navitus departments to ensure accurate, timely claim adjudication across diverse networks.

This role may include after-hours work and requires adapting to industry changes while supporting internal customers and client meetings. Remote work is available in the US.

Qualifications

• Associate’s degree or equivalent work experience.
• 2–3 years of experience with Navitus systems and processes.
• Ability to guide and educate associates within current to lower-level roles.
• Experience with mid-sized to large clients of moderate to high complexity.
• Experience with health plan business with minimal guidance.
• Proficiency with Navi-ClaimRx, Microsoft Office, Formulary Management, Request Management, GEMS, and Qlik tools.

Responsibilities

• Configure new client implementations and network additions timely and accurately.
• Maintain knowledge of adjudication system screens to design standard and custom configurations.
• Ensure network design compliance with HIPAA, NCPDP, and internal standards.
• Perform quality assurance and root-cause analysis for network changes.
• Use workflow tools for troubleshooting and responding to complex questions.
• Support client meetings, audits, and new program implementations.
• Adapt to industry changes and evolving technology.
• Lead process improvements, cost reduction, and automation efforts.
• Create and maintain training materials, work instructions, and policies.
• Provide support for client and sales presentations and respond to RFP questions.

Skills

Network configuration

HIPAA compliance

Analytical thinking

Client collaboration

Education

Associate’s degree or equivalent

Tools

Navi-ClaimRx

Microsoft Office

Formulary Management

Request Management (Connectus, Service Desk, Responsive)

Government Programs Error Management (GEMS)

Reporting (3D QlikView/QlikSense)

Job description

Navitus Health Solutions is seeking an Analyst III, Network Configuration to join our team. You will configure pharmacy networks in the adjudication system and work with multiple Navitus departments to ensure accurate, timely claim adjudication across diverse networks.

This role may include after-hours work and requires adapting to industry changes while supporting internal customers and client meetings. Remote work is available in the US.