Remote Government Programs Tech Ops Analyst

Navitus Health Solutions; United States; On-site; USD 43,780 - 52,119; Full time

Benefits offered by this job

Health insurance

Dental & Vision insurance

Paid time off

Parental leave

401(k) match

Adoption assistance

Flexible spending account

Educational assistance

Professional membership assistance

Referral bonus program

Job summary

Navitus Health Solutions is seeking an Analyst, Tech. Operations Government Programs to join our team. The role focuses on executing Government Programs processes accurately and in CMS compliance, supporting enrollment admin, FIR, PDE errors, COB, and EOB tasks.

You will collaborate with internal teams and external partners, manage timelines, and document processes. A background in pharma claims adjudication or health plan operations plus strong communication is valued.

Qualifications

• Bachelor/Associate Degree or 2 years of related work experience, or 4 years with high school diploma.
• 1+ years’ work experience
• Experience in pharmaceutical claims adjudication systems, retail pharmacy, or health plan organization preferred
• Support compliance program objectives
• Ability to interact cooperatively and respectfully with other employees

Responsibilities

• Execute Government Programs processes accurately and in compliance with CMS regulations.
• Oversee schedules and alert management when timelines are at risk.
• Ensure process documentation reflects current steps and update as needed.
• Assist SMEs in defining process steps and documenting requirements.
• Review errors and prioritize reconciliation per State and Federal guidance.
• Communicate with Employer Groups, Clients, Agencies, vendors and Navitus departments to resolve issues.
• May work outside normal hours to complete time-sensitive processes.
• Other duties as assigned.

Skills

Pharmaceutical claims adjudication

Analytical thinking

Communication skills

Education

Bachelor/Associate Degree

4 years work experience or 2 years with associate

Tools

Claims adjudication systems

Health plan operations tools

Job description

Navitus Health Solutions is seeking an Analyst, Tech. Operations Government Programs to join our team. The role focuses on executing Government Programs processes accurately and in CMS compliance, supporting enrollment admin, FIR, PDE errors, COB, and EOB tasks.

You will collaborate with internal teams and external partners, manage timelines, and document processes. A background in pharma claims adjudication or health plan operations plus strong communication is valued.