[Hiring] Senior Systems Analyst, Claim Adjudication @Navitus Health Solutions

Role Description

Due to growth, we are adding a Sr. Systems Analyst, Claim Adjudication to our team!

The Sr. Systems Analyst, Claim Adjudication position ensures efforts are in alignment with the Claim Adjudication Technology team to support customer-focused objectives and the IT Vision, a collaborative partner delivering innovative ideas, solutions and services to simplify people’s lives. The Sr. Systems Analyst role is a claim adjudication system expert with deep knowledge of the claim processing system. This position will triage, support and test the claim adjudication system issues and enhancements. The Sr. Systems Analyst is also responsible for understanding and sharing the global system impact of enhancements and development activities by focusing on the capabilities and limitations of the claim adjudication system. The Sr. Systems Analyst will identify potential risks within the claim adjudication system, deliver quantified fact-based supporting details and provide a detailed mitigation plan.

Is this you? Find out more below!

Responsibilities

• Maintain strong working relationships with members of the business and IT
• Maintain in-depth detailed knowledge of the claim adjudication system capabilities and limitations
• Provide subject matter expertise, participate in the design of innovative solutions to improve system configuration, claim processing, accuracy and efficiency of claims processing, and support large effort initiatives within the claims adjudication space
• Identify risk, deliver quantified fact-based supporting details and provide a recommendation and detailed plan for mitigation
• Mentoring of less experienced team members
• Peer review to evaluate performance of team members as requested
• Ensure accurate security configuration within the claims adjudication platform to minimize unauthorized access
• Collaborate with functional areas and share new system capabilities
• Review and understand NCPDP workgroup outcomes, participate in appropriate NCPDP task groups, share industry best practices and standards
• Other duties as assigned

Qualifications

• A two-year college or university degree and/or a minimum of five years of work experience is required
• Professional PBM industry work experience is required
• Knowledge of applicable data privacy practices and laws is preferred
• Healthcare industry practices and HIPAA knowledge
• Experience as a member of a multi-disciplinary team
• Understanding of Agile methodology a plus
• 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!

Company Description

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

Hiring Manager: Elaine Weber Spatz

Pay Range: USD $71,716.18 - USD $86,405.04 /Yr.