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Navitus Health Solutions

Director, Rebate Operations

Navitus Health Solutions, Anaheim, California, United States, 92808

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Director Of Rebate Operations

Navitus Health Solutions is seeking a Director of Rebate Operations to join our team! This is a great role for someone with deep technical expertise working at a mid-scale rebate operation.

Reporting to Vice President, Formulary and Industry Relations, the Director of Rebate Operations is responsible for all operational aspects of Navitus' rebate program including but not limited to core operations, client operations, rebate optimization, sales support, pricing / guarantees, point of sale rebates and vendor management.

Is this you? Find out more below!

Responsibilities How do I make an impact on my team?

Data flow between Navitus Rebates team and other internal stakeholders like finance, analytics, sales and account management

Account Reconciliation file receipt, analysis and furnishing the necessary data so finance can invoice clients

Prospective Reporting This includes forecasting / projecting rates based on existing data, making assumptions and documenting such assumptions / caveats in calculating forecasted rates using existing data. Creating a potential bid grid based on known data components, again making and documenting assumptions. Constantly comparing actuals vs. forecasted to finetune assumptions. Forecasting guarantees based on rates, utilization and other factors like inflation

Retrospective Reporting Ensure all client reports are generated timely and accurately. Analyzing the data to ensure clients are receiving maximum rebates. If there are gaps, identify the reasons for those gaps and work with GPO to correct those

Rebate Optimization Analyze client formulary against best formulary placement with pharma / GPO to then supply the data / information that would be needed by our contractors to have meaningful conversations with pharma / GPO and our clients in order to maximize client rebates while still maintaining our lowest net cost philosophy

Operationalize the service working closely with other operational areas like formulary and Claim adjudication to ensure accuracy of the set-up

Tracking performance of vendors against guarantees, tracking the dispute resolution process and creating dashboards that capture current state in a comprehensive manner

For each of the processes that are required to ensure we deliver the lowest net cost to our clients, the Director shall ensure there is good documentation around Workflows, Policies and Procedures, Detailed Work Instructions

Build appropriate metrics for the department. This includes operational metrics like activity metrics, outcome-oriented metrics etc

Work with other internal stakeholders like analytics, client financial / sales support teams to ensure a robust methodology is deployed when forecasting / predicting based on current data. Document the methodology and clearly note the assumptions / caveats around risk, knowns and unknowns

Other duties as assigned

Qualifications What our team expects from you?

A minimum of 4-year degree OR Equivalent work experience in related work environment

Minimum of 2 years in a PBM or equivalent setting

Proven experience in designing an operation, building processes scaling and automation

Proven track record of process improvement / system enhancements

Experience with tools / systems around automation of processes is highly preferred

Proven track record of collaboration with multiple stakeholders internal and external

A very participative leadership record

Proven track record of keeping employees highly motivated and engaged

Experience in working with Senior Leadership within an organization

Participate in, adhere to, and support compliance program objectives

The ability to consistently interact cooperatively and respectfully with other employees

Benefits What can you expect from Navitus?

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!

Location: Address

Remote

Location: Country

US

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