Product Manager, Med-D
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Job Description
Product Manager overseeing Medicare Part D processes and CMS compliance at Navitus, a pharmacy benefits manager. Leading implementations, audits, corrective actions, and client support.
Responsibilities:
- Provide product management for the Navitus Medicare Part D program
- Lead efforts to design, develop, implement, and oversee Medicare Part D processes supporting regulatory requirements and client expectations
- Review and act upon CMS technical and business process/operational guidance
- Ensure appropriate software, processes/procedures, and oversight monitoring are implemented
- Develop and maintain subject matter expertise related to Medicare Part D rules and regulations
- Monitor and interpret CMS regulations, guidance, and system changes
- Manage development, implementation, and maintenance of Medicare Part D processes for all Medicare Part D clients
- Develop project plans and lead projects enhancing the Medicare Part D program
- Implement requirements using project management tools and principles
- Establish stable processes and effective monitoring mechanisms
- Perform operational oversight for services delegated by Medicare Part D clients and align oversight with identified risks
- Identify and implement process improvements to improve efficiency, automation, scalability, and compliance/risk mitigation
- Implement corrective actions addressing compliance issues and ensure root-cause correction and monitoring
- Support CMS audits and client oversight audits
- Provide subject matter expert support to the organization and Med D clients
- Support Sales efforts with Medicare Part D-specific RFP responses as needed
- Ensure policies and procedures document compliance with Part D/regulatory requirements
- Perform oversight to ensure guidance citations are accurate and current
- Conduct periodic audits of functional-area performance
- Perform other duties as assigned
Requirements:
- 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
- Experience in government program compliance oversight and CMS audit protocol highly desired
- Participate in, adhere to, and support compliance program objectives
- The ability to consistently interact cooperatively and respectfully with other employees
Benefits:
- 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!
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