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Role Description

The Advisor, Industry Standards is responsible for compliant implementation and oversight of the National Council of Prescription Drug Programs (NCPDP) Standards. This includes:

• Facilitating internal awareness of the impacts of NCPDP standard changes
• Assisting in interpreting and conveying NCPDP standards to key stakeholders
• Actively participating in NCPDP Work Groups (WG) and Task Groups (TG)
• Collaborating and coordinating with various internal stakeholders related to compliance of the claims adjudication system with NCPDP standards
• Building relationships, communicating effectively, and driving decision making
• Gathering specific business requirements and leading the execution of program enhancements to comply with industry requirements end to end

Responsibilities

• Actively participate in NCPDP Task Groups and Work Groups to represent Navitus’ perspective on proposed new standards and modifications to existing standards
• Engage directly with clients and auditors as a subject matter expert and strategic consultant
• Develop and utilize networking relationships throughout the industry to collaborate on guidance and clarification of NCPDP standards
• Summarize new applicable NCPDP standards and present to Navitus leadership and departments
• Provide subject matter expertise (SME) in support of the development of functional and business requirements for claims adjudication platform
• Identify and research issues impacting functional area work, collaborating with internal and external customers to resolve
• Develop detailed knowledge of the claim adjudication system capabilities and limitations
• Review prescription benefit standards changes and translate them into business and system requirements
• Facilitate testing with pharmacies for NCPDP compliance, including development of test plans and payor sheet updates
• Other duties as assigned

Qualifications

• Minimum 2 years’ work experience in PBM Operations required
• NCPDP member and standards expertise with active participation in NCPDP work groups and task groups preferred
• PBM industry experience required
• Experience in review and interpretation of complex regulatory guidance
• 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!