Senior Manager, Quality Assurance, Benefit Configuration
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Job Description
Sr. Manager leading Quality Assurance function focused on benefit configuration verification at Navitus. Ensuring alignment with client requirements across all lines of business.
Responsibilities:
- Lead and oversee a team of Quality Assurance Analysts, ensuring effective execution of benefit configuration testing, validation, and audit activities.
- Ensure accurate and timely completion of complex quality assurance for new client implementations, benefit changes, and ongoing maintenance across all lines of business.
- Establish and enforce quality assurance standards, procedures, and audit methodologies, ensuring compliance with internal requirements.
- Provide oversight on root cause analysis, issue resolution, and corrective action planning, ensuring issues are identified, tracked, and resolved effectively by partnering with Issue Management Team.
- Collaborate cross-functionally to drive process improvement, automation, and scalable initiatives to enhance efficiency, reduce risk, and improve testing outcomes.
- Oversee development and maintenance of training materials, job aids, and standard operating procedures, ensuring consistency across the team.
- Support and lead client interactions, including presentations, audits, implementations, and RFP responses related to quality assurance practices.
- Ensure effective use of workflow management, issue tracking, and reporting tools to support visibility, accountability, and performance tracking.
- Lead and inspire high-performing teams by providing strategic direction, aligning talent and resources with organizational goals, and driving operational excellence across key initiatives.
- Other duties as assigned.
Requirements:
- Bachelor's degree or equivalent work experience required.
- 6+ years of relevant work experience in the healthcare industry in benefit confirmation, operations, or quality assurance required.
- PBM experience preferred.
- 5+ years of experience leadership in PBM, healthcare operations, or similar industry required.
- 4+ years of work experience using MS Excel filtering, sorting, and analyzing data with ability to write complex formulas required.
- Strong PBM Quality Assurance validation and testing knowledge preferred.
- Knowledge of government programs such as Medicare or Medicaid, network pricing, and formulary required.
- 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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