Remote Medicare Part D Product Manager

Navitus; Topeka (KS); Remote; USD 110,000 - 125,000; Full time

Benefits offered by this job

Health insurance

Paid time off

Parental leave

Holidays

401K match

Adoption assistance

Flexible Spending Account

Educational assistance

Referral bonus

Job summary

Navitus Health Solutions is seeking a Product Manager to lead product management for the Medicare Part D program, ensuring design, development and oversight of processes that meet CMS guidance and client expectations. The PM will manage projects, implement regulatory requirements, and oversee operational processes across multiple Part D clients.

The role emphasizes developing SME knowledge, monitoring CMS guidance, and driving process improvements to ensure compliant, scalable solutions.

Qualifications

• Bachelor’s degree or equivalent work experience in Medicare Part D required.
• 3 years of Medicare Part D experience required.
• Expertise in Medicare Part D regulations and demonstrated accountabilities in areas such as coverage determinations, appeals and grievances, prior authorizations, formulary management, transition monitoring, etc. is preferred.

Responsibilities

• Develops and maintains deep subject matter expertise related to Medicare Part D rules and regulations
• Monitors and interprets CMS regulations, guidance, and system changes. Ensures the Medicare Part D function meets all regulatory requirements.
• Manages the development, implementation, and maintenance of Medicare Part D processes for all Medicare Part D clients. Develops the necessary project plans and leads projects that enhance the Medicare Part D program. Implements requirements utilizing project management tools/principles. Ensures process is stable and effective monitoring mechanisms are established.
• Performs operational oversight for services delegated to Navitus by Medicare D clients. Aligns oversight mechanisms with identified risks.
• Identifies/implements process improvements to gain efficiencies, improve automation and/or mitigate non-compliance/risk. Ensures process is scalable for future growth. Strives for "best practice" where possible.
• Actively participates in implementing corrective action to address compliance issues. Ensures the actions are correcting the root cause, preventing future reoccurrence and that appropriate detection/monitoring mechanisms are in place. Engages Medicare Compliance leadership with all non-compliance related issues and/or when obstacles arise. Supports compliance efforts including CMS audits and client oversight audits.
• Provides SME support to the organization and to Navitus' Med D clients related to guidance interpretation; operational processes that support the Med D requirements; problem solving of issues/questions; and implementation/reimplementation support.
• Supports Sales efforts with Request for Proposal (RFP) responses specific to Medicare Part D, as needed.
• Ensures that policies and procedures exist to document that Navitus complies with all Part D/regulatory requirements. Performs oversight to ensure guidance citations are accurate and current. Conducts periodic audits to ensure the functional areas are performing duties consistent with the documented policy.
• Other duties as assigned

Skills

Medicare Part D knowledge

Regulatory compliance

Project management

Education

Bachelor’s degree or equivalent in related field

Job description

Navitus Health Solutions is seeking a Product Manager to lead product management for the Medicare Part D program, ensuring design, development and oversight of processes that meet CMS guidance and client expectations. The PM will manage projects, implement regulatory requirements, and oversee operational processes across multiple Part D clients.

The role emphasizes developing SME knowledge, monitoring CMS guidance, and driving process improvements to ensure compliant, scalable solutions.