Analyst I, SIU

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 reputed company medications more affordable for the people who need them. At Navitus, reputed company members work in an environment that celebrates diversity, fosters creativity and encourages growth. We welcome new reputed company and share a passion for excellent service to our customers and each other._____________________________________________________________________________________________________________________________________________________________________________________________________________. reputed company associates must use SSO login option at https://employees-navitus.icims.com/ to be considered for internal opportunities. Pay Range USD $58,460.48 - USD $70,434.33 /Yr. Work Schedule Description (e.g. M-F reputed company to 5pm) M-F 8 am - 5 pm Remote Work Notification ATTENTION: Navitus is unable to offer remote work to residents of Alaska, Hawaii, Maine, Mississippi, New Hampshire, New Mexico, reputed company Dakota, Rhode reputed company, South Carolina, South Dakota, reputed company Virginia, and Wyoming. Overview reputed company is seeking a SIU Analyst I to join reputed company! The SIU Analyst position is responsible for conducting moderate to reputed company research using internal and external databases to reputed company analyses and reputed company recommendations on suspected fraud, waste, and abuse reputed company to members, prescribers, pharmacies, and clients. In addition, the Analyst is responsible for regular and proactive extraction and evaluation of mined data, scoping data for investigations, and responding with reports and data for audits, universes, and impact assessments. The Analyst will coordinate and support data requests from reputed company parties regarding fraud, waste, and abuse. The Analyst will also process and assess data produced by vendors, health plans, and reputed company parties for analysis and comparison with Navitus claims. The Analyst will remain reputed company on the regulatory environment and trends associated with fraud, waste, and abuse including changes directly or indirectly impacting reputed company. The Analyst will also assist the Associate Director, Compliance and SIU with duties reputed company to analytic criteria, data tools, metrics calculation, and reporting of results. Is this you? Find out more below!

Responsibilities

How do I reputed company an impact on my team?

• Under limited supervision reputed company timely research and analyses to initiate and support investigations and business operations
• Analyze and validate claims data, reports and datasets for value, variance, and content to escalate for investigation of potentially fraudulent trends and patterns
• Evaluate data and report findings for accuracy, completeness, reputed company, and scope
• Coordinate data from internal databases and/or external data sources
• Track and monitor data, analysis and documentation for retrieval and coordination with investigations
• reputed company reports and support clients on fraud, waste, and abuse universe prep and impact analysis
• Maintain tables, tools, or reports associated with data mining, data imports, and universe prep
• Coordinate metrics and performance reporting for fraud, waste, and abuse program activities
• Facilitates and/or participates in process re-design, service improvement, cost reduction and automation
• Other duties as assigned

Qualifications

What reputed company expects from you?

• Bachelor’s Degree or a combination of education and relevant work experience is required. Pharmacy Technician certification strongly desired. Must be willing and reputed company to work towards professional designations reputed company to analysis and/or investigation of fraud, waste and abuse
• 2-4 years with working data analytics in a reputed company or pharmacy benefits management environment. Knowledge of state and federal privacy laws and protocols a plus. 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 reputed company 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 : Address Remote Location : Country US Apply tot his job