Director PBM Technical Operations

JOB REQUIREMENTS: Director, PBM Technical Operations Location US- ID2025-5372 Category Administration Position Type Full-Time Remote YesCompany Navitus About Us Navitus - Putting People First in Pharmacy -Navitus was founded as an alternative to traditional pharmacy benefitmanager (PBM) models. We are committed to removing cost from the drugsupply chain to make medications more affordable for the people who needthem. At Navitus, our team members work in an environment thatcelebrates diversity, fosters creativity and encourages growth. Wewelcome new ideas and share a passion for excellent service to ourcustomers and eachother._____________________________________________________________________________________________________________________________________________________________________________________________________________.Current associates must use SSO login option atto be considered for internalopportunities. Pay Range USD $120,525.00 - USD $150,656.00 /Yr. STARBonus % (At Risk Maximum) 15.00 - Director, GM of GP, PIC Work ScheduleDescription (e.g. M-F 8am to 5pm) M-F 8am to 5pm Remote WorkNotification ATTENTION: Navitus is unable to offer remote work toresidents of Alaska, Hawaii, Maine, Mississippi, New Hampshire, NewMexico, North Dakota, Rhode Island, South Carolina, South Dakota, WestVirginia, and Wyoming. Overview Do you have experience at a PBM? NavitusHealth Solutions is seeking a Director, Technical Operations with noless than 5 years of experience at a PBM, health plan, or managed careenvironment to join our team This is not a call center or generaloperations leadership roles. The Director, Technical Operations (DTO) isresponsible for providing regulatory interpretation, operationalexpertise and oversight of technical programs for Government Programswhich include enrollment/eligibility, regulatory encounter submissionand reconciliation, claims adjudication accuracy, EOB Administration,recoveries processes, EGWP enrollment, coordination of benefits,reprocessing/refund/recoveries solution deliverables, M3P, vendorcontract management and RDS Administration. The Director will recommend,develop, implement, monitor and evaluate department goals, objectives,processes, and policies and procedures within the scope of thedepartment's responsibilities. The DTO is responsible for thedevelopment, implementation and ongoing oversight of the technicaloperations and activities needed to support Government Programs. Thisindividual will ensure that policies, procedures, and CMS and stateprogram requirements are implemented to achieve effective, efficient,auditable and compliant Medicare, Medicaid and Exchange ClaimsAdjudication. Is this you? Find... For full info follow applicationlink. Navitus Health Solutions is an Equal Opportunity Employer:Disabled/Veterans/Male/Female/Minority/Other APPLICATIONINSTRUCTIONS: Apply Online: ipc.us/t/F4D095374FF1445D

Created: 2026-01-16