Sr. Analyst, Compliance Oversight Med-D

Navitus Health Solutions, LLC; United States; Remote; USD 65,000 - 80,000; Full time

Job summary

An established industry player is seeking a Sr. Analyst for Compliance Oversight in their Government Programs department. This role is pivotal in ensuring compliance with CMS regulatory audits and internal monitoring activities for Medicare. The ideal candidate will possess deep expertise in Medicare Part D and a strong background in auditing and process improvement. You will be responsible for facilitating audits, developing corrective actions, and collaborating with various teams to ensure compliance objectives are met. Join a company that values diversity and fosters a culture of growth, offering top-tier benefits and a supportive work environment.

Benefits

Health insurance

Dental insurance

Vision insurance

20 days paid time off

4 weeks paid parental leave

9 paid holidays

401K company match up to 5%

Adoption Assistance Program

Flexible Spending Account

Qualifications

• 3+ years of experience in audits and operational monitoring.
• Expertise in Medicare Part D is highly preferred.

Responsibilities

• Facilitates CMS regulatory and client-initiated audits.
• Develops and maintains subject matter expertise in Medicare Part D.
• Acts as a liaison to internal business partners for audit findings.

Skills

Auditing

Process Improvement

Reporting

Operational Monitoring

Medicare Part D

Microsoft Excel

Microsoft Office Suite

Education

Bachelor's degree

Tools

Microsoft Excel

Microsoft Office Suite

Job description

Company

Navitus

About Us

Navitus - Putting People First in Pharmacy - Navitus was founded as an alternative to traditional pharmacy benefit manager (PBM) models. We are committed to removing cost from the drug supply chain to make medications more affordable for the people who need them. At Navitus, our team members work in an environment that celebrates diversity, fosters creativity and encourages growth. We welcome new ideas and share a passion for excellent service to our customers and each other.

Pay Range

USD $65,686.00 - USD $79,140.00 /Yr.

Work Schedule Description

M-F 8am-5pm, CST

Remote Work Notification

ATTENTION: Navitus is unable to offer remote work to residents of Alaska, Hawaii, Maine, Mississippi, New Hampshire, New Mexico, Rhode Island, South Carolina, South Dakota, West Virginia, and Wyoming.

Overview

Due to growth, we are adding a Sr. Analyst, Compliance Oversight Med-D to our Government Programs department!

The Sr. Analyst, Compliance Oversight Med-D is directly responsible for providing support for CMS Regulatory Audits, client-initiated audits including Pre-Delegation and Delegation Audits along with conducting internal audit and monitoring activities for Navitus’ Medicare line of business. The Sr. Analyst, Compliance Oversight Med-D (SACO) will act as the facilitator for Pre-Delegation/Delegation Audits and support timely delivery of audit deliverables. The SACO will conduct quality assurance review on all audit and monitoring activities. The SACO will be responsible for providing monthly/quarterly audit and monitoring reports to the internal audit review committee, and business partners/clients. The SACO will coordinate Process Improvement/Remediation Plans as needed. The SACO will be primarily responsible for interfacing with the Government Programs Senior Regulatory Adherence and Audit Manager to coordinate delivery of the monthly/quarterly oversight reports, as outlined in the Audit and Monitoring work plan for EGWP. This SACO will also interface with various functional teams throughout Navitus.

Is this you? Find out more below!

Responsibilities

How do I make an impact on my team?

• Develops and maintains deep subject matter expertise related to Medicare Part D.
• Acts as the internal audit facilitator for Pre-Delegation/Delegation Audits including confirmation of audit scope, deliverables and timeframes.
• Acts as a liaison to internal business partners in interpreting audit findings, preparing and completing audit responses in the required timeframe, developing corrective actions as appropriate or requested by client(s), and monitoring to ensure that corrective actions are successfully implemented.
• Review and evaluate the effectiveness of corrective action plans and provide comprehensive follow-up to Medicare Compliance leadership.
• Acts as a mentor and supports onboarding a new COA, as applicable.
• Independently facilitates CMS regulatory and client-initiated audits:
• Performs audits per the schedule that is developed as part of the annual Audit and Monitoring Work Plan.
• Participate in, adhere to and support compliance and diversity, equity, and inclusion program objectives.
• Other duties as assigned.

Qualifications

What our team expects from you?

• Bachelor’s degree, or equivalent experience, required.
• 3+ years’ experience and expertise in audits, facilitating process improvement, reporting, and/or operational monitoring required.
• Experience and expertise in Medicare Part D highly preferred.
• Experience with Microsoft Excel and Office Suite products.
• Participate in, adhere to, and support compliance program objectives.
• The ability to consistently interact cooperatively and respectfully with other employees.

What 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.

#LI-Remote

Location

Remote

Country

US