Specialist, Formulary Operations-Remote

Salary Range:$19.03 To 23.73 Hourly

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 make medications more affordable for the people who need them.   At Navitus, our team members work in an environment that celebrates diversity, fosters creativity and encourages growth.  We welcome new ideas and share a passion for excellent service to our customers and each other.  

We are 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.

The Specialist, Formulary Operations will perform the daily, weekly, and monthly/periodic administrative functions necessary to update and maintain the formularies for Navitus’ clients for all lines of business. This includes working with the Formulary Services Supervisors to make all changes to the formulary information accessed by clients, as well as day to day formulary maintenance; and having advisory input to how this information is presented, maintained, and reviewed.

Is this you? Find out more below! 

How do I make an impact on my team?  

  • Take formulary information from various sources including the Pharmacy and Therapeutics Committee, the Formulary Advisory Committee, and Clinical Account Executives to coordinate the process of entering the information into the formulary change database and communicating changes to Benefits Systems and Auditing.  
  • Maintain up-to-date formulary documents available through multiple resources including ePocrates, web portals, and e-prescribing.  
  • Review weekly Medispan Reports for new drugs and drug changes that impact the formulary.
  • Collaborate with clinical and client services throughout new client implementations to capture the formulary information needed for plan set-up.
  • Trouble-shoot various formulary / set-up questions.
  • Maintain open lines of communication with other functional areas/departments
  • Maintain an environment of collaboration and cooperation with coworkers
  • Be an effective ambassador of Navitus’ vision, mission, values, goals and policies
  • Participate in meetings and committees as requested/assigned
  • Approximate travel required (5-10%).

What our team expects from you? 

  • A minimum of a High School diploma plus knowledge relating to pharmacy practice is required.  
  • CPhT/experience as a pharmacy technician strongly preferred.  
  • Previous experience with pharmacy claims software is a definite plus.
  • Must have a working knowledge of pharmacy practice including drug names (brand vs. generic, NDC, GPI) and claims processing background (either from managed care or community practice).
  • Familiarity with Formulary, Prior Authorization, Step Therapy, and other utilization management tools preferred.
  • Strong computer skills (Excel, Word, Outlook).
  • Strong communication skills (verbal and written).
  • Needs to work well both independently and in a team setting.
  • Must be able to exercise appropriate judgment as necessary. 
  • Requires a high level of initiative and creativity.  
  • 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?

  • Hours/Location: Monday-Friday 8:00am-4:30pm, CST-Remote
  • Paid Volunteer Hours
  • Educational Assistance Plan and Professional Membership assistance
  • Referral Bonus Program – up to $750!
  • Top of the industry benefits for Health, Dental, and Vision insurance, Flexible Spending Account, Paid Time Off, Eight paid holidays, 401K, Short-term and Long-term disability, College Savings Plan, Paid Parental Leave, Adoption Assistance Program, and Employee Assistance Program

Startegic Media Buyer

Department: University Marketing

Reports to: Director of Advertising & Marketing Analytics

Location / Campus: Remote

Job Type: Full Time, Exempt

Salary: $85,000.00 / year

Position Overview

Under the direction of the Director of Advertising and Marketing Analytics, the Strategic Media Buyer is responsible for the tactical planning, purchase, execution and delivery of digital channels that are part of approved media plans. Assists in establishing appropriate tactical media strategies and budgets. Previous experience in planning, buying, and managing advertising in the areas of SEM and social media, and with media vendors for programmatic display and video, traditional, OOH, and emerging media is required. Must be well versed in all types of media and must stay current with the rapidly changing media landscape. Must have a working and proficient understanding of media measurements and how to creatively apply them in order to meet or exceed Antioch’s lead generation and brand goals.

In addition to these duties, this position will be responsible for assisting in the establishment of processes and for adhering to existing processes and workflow, while suggesting updates to increase efficiency and effectiveness.

Essential Job Functions

Plan, manage and execute the day-to-day media buying operations, including media research and analysis, implementation/buying, campaign administration, and reporting
Develop, implement and optimize digital strategies and initiatives through Google, DSPs, social media platforms, and vendors such as IHeartRadio, newspapers, etc.
Interact with outside vendors and external business partners regarding various facets of Antioch’s media activity, such as media authorizations, insertion orders, and reporting
Attend meetings to present advertising strategies, campaign results and recommendations
Create and manage digital media flowcharts, insertion orders, billing, reporting, and reconciliation
Organize and send/upload digital creative assets to media outlets
Ability to stay up-to-date on the latest tools and trends
Create and/or contribute to the design of the advertising assets and creative
Other duties as assigned
Minimum requirements

Bachelor’s degree in Marketing, Communications, or Advertising (preferred)
Must have 1-3 years’ digital media planning/buying experience (with examples to show or reference)
Experience developing and executing SEM, social media, and programmatic campaigns
Knowledge, Skills and Abilities

Advanced knowledge of digital marketing platforms, including Google, Facebook, and LinkedIn or ability to create and manage digital marketing campaigns in a variety of platforms, including Google, Facebook and LinkedIn.
Computer proficiency; advanced knowledge of Excel or Sheets is a plus
Proactive problem-solving ability
Meticulous attention to detail and accuracy
Excellent communication skills, both written and verbal
Strong organizational and analytical skills
Understanding of marketing fundamentals
Deadline-oriented with a sense of urgency
Ability to collaborate well with staff, clients, and vendors at all levels
Self-starter, high energy, assertive, take-charge personality
Ability to get up to speed quickly; desire to work in a fast-paced, rapidly evolving
Hours of Employment

This is a full-time position serving a national university. A work schedule will be established in consultation with the supervisor. The typical work week is Monday through Friday, 40 hours per week with occasional evening and/or weekend hours.

Work Location
Remote

Benefits Summary

Voluntary Health, dental and vision plan and flexible spending account options; employer retirement plan contribution of 6%; voluntary salary deduction to a pre-tax or post-tax retirement account; employer paid life insurance and short term disability; voluntary supplemental life insurance, long-term disability, accidental death/dismemberment, critical illness, and accident coverage plans; vacation accrues monthly (3 weeks from 0 – 5 years; 4 weeks after 6 years; carry-over allowed up to 3.75 days 0 – 5 years; up to 5 days, after 6 years and up); 12 days per year sick leave (carry-over up to 65 days); 15 paid holidays; tuition remission for employees and dependents at Antioch University campuses; and employee paid options with AFLAC, LegalShield, and Liberty Mutual.

Survey Junkie

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Credit Balance Specialist

Thank you for considering a career at Ensemble Health Partners!

Ensemble Health Partners is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They offer end-to-end revenue cycle solutions as well as a comprehensive suite of point solutions to clients across the country.

Ensemble keeps communities healthy by keeping hospitals healthy. We recognize that healthcare requires a human touch, and we believe that every touch should be meaningful. This is why our people are the most important part of who we are. By empowering them to challenge the status quo, we know they will be the difference

The Opportunity:

Job Description
The Credit Balance Specialist performs review of all credit balances within Revenue Cycle. Job duties include, but are not limited to, analyzing all credit balances both patient and insurance. They will process patient and insurance refunds. They will perform these duties while meeting the goals of Ensemble, as well as meeting the regulatory compliance requirements.

Essential Functions:

  • Credit Balance Analyst will review accounts with a credit balance.
  • Generate overpayment letters to insurance carriers
  • Review overpayment requests from insurance carriers
  • Prepare Medicare Quarterly Balance Report
  • Performs other duties as assigned

Education Requirements & Certifications:

  • High School Diploma, GED, or Equivalent Experience
  • Ensemble Associate required to obtain CRCR certification within 9 months of hire.

Required Experience:

  • Some Post High Education (Trade School, College, etc.) preferred
  • Healthcare Cash Posting, Registration, Medical Office, Insurance, or billing back-ground preferred
  • Must pass typing test of thirty-five (35) words per minute (Error Adjusted)
  • Must pass 10-key test of 10,000 KPM and >95% Accuracy
  • Must demonstrate basic computer knowledge and skills
  • Revenue Cycle Proficiency test – pass rate of 50% or above
  • Pass basic standard math test as provided by the Education department

Join an award-winning company

Three-time winner of “Best in KLAS” 2020-2022

2022 Top Workplaces Healthcare Industry Award

2022 Top Workplaces USA Award

2022 Top Workplaces Culture Excellence Awards

Innovation

Work-Life Flexibility

Leadership

Purpose + Values

Bottom line, we believe in empowering people and giving them the tools and resources needed to thrive. A few of those include:

Associate Benefits – We offer a comprehensive benefits package designed to support the physical, emotional, and financial health of you and your family, including healthcare, time off, retirement, and well-being programs.
Our Culture – Ensemble is a place where associates can do their best work and be their best selves. We put people first, last and always. Our culture is rooted in collaboration, growth, and innovation.
Growth – We invest in your professional development. Each associate will earn a professional certification relevant to their field and can obtain tuition reimbursement.
Recognition – We offer quarterly and annual incentive programs for all employees who go beyond and keep raising the bar for themselves and the company.
Ensemble Health Partners is an equal employment opportunity employer. It is our policy not to discriminate against any applicant or employee based on race, color, sex, sexual orientation, gender, gender identity, religion, national origin, age, disability, military or veteran status, genetic information or any other basis protected by applicable federal, state, or local laws. Ensemble Health Partners also prohibits harassment of applicants or employees based on any of these protected categories.