Qureos Mentor

Navitus Health Solutions / Lumicera Health Services

<div>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 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._____________________________________________________________________________________________________________________________________________________________________________________________________________. Current associates must use SSO login option at https://employees-navitus.icims.com/ to be considered for internal opportunities. Pay Range: USD $150,000.00 - USD $180,000.00 /Yr. STAR Bonus % (At Risk Maximum): 5.00 - Salaried Non-Management except pharmacists Work Schedule Description (e.g. M-F 8am to 5pm): Core business hours Remote Work Notification: ATTENTION: Navitus is 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. Overview:
<div>
The IT Strategic Sourcing Lead/Vendor Procurement Principal is an individual contributor role responsible for driving complex vendor negotiation and acquisition that align with enterprise strategy transformation objectives.</div><div></div><div><br>
This position ensures that large IT procurement activities support modernization initiatives, regulatory compliance, and operational efficiency under the Strategic Transformation Officer (STO). This role promotes critical advisory and sourcing to ensure support for business initiatives ensuring operational efficiency, scalability, and innovation.</div><div><br>
This role collaborates with existing organizational vendor-related roles and external consultants to champion and ensure vendor expectations are met or exceeded. This role will consult with and support stakeholders to ensure that vendors and their products promote sustainable technology modernization that adheres to regulatory obligations, accelerates enterprise transformation, ensures business alignment and supports the organization&rsquo;s multi-year growth strategy.</div><div><br>
The Vendor Procurement Principal is accountable for initiating the lifecycle of this strategic value stream including governance, intake, prioritization, capacity alignment, budget stewardship, risk/issue controls, vendor selection, change management and transparent reporting to ensure decision clarity, market readiness, investment accountability, and organizational performance.</div>
Responsibilities:
<ul><li>Embed procurement strategies within the five-year roadmap, ensuring vendor partnerships accelerate technology modernization, margin improvement, and operational scalability.
</li><li>Support initiatives tied to the Board-approved plan, including investments in enterprise platforms and services that deliver a tech-enabled, human-centered experience.</li><li>Lead end-to-end vendor acquisition processes, including RFP development, ROI analysis, and negotiation.
</li><li>Partner with internal stakeholders and external consultants to ensure vendor solutions align with transformation goals and regulatory obligations.</li><li>Draft and review statements of work and service-level agreements (SLAs) tailored to business needs.
</li><li>In collaboration with business owners, establish and enforce SLAs and performance guarantees within vendor contracts to ensure measurable service delivery standards, including defining KPIs, monitoring compliance, and driving corrective actions when commitments are not met.
</li><li>Develop and issue RFIs to applicable vendors and coordinate applicable demos, proofs of concept and implementation needs for efficient and effective product selection and manageable cost structure.</li><li>Collaborate with Legal, Compliance, and Vendor Risk teams to mitigate risks and ensure adherence to contract requirements, vendor policies and business Associate and First Tier, Downstream and Related Entity (FDR) criteria.</li><li>Maintain procurement documentation and provide transparent reporting on vendor performance, financial impact, and risk controls.</li><li>Support governance processes for prioritization, capacity alignment, and budget stewardship.</li><li>Align with vendor business owners to install vendor performance oversight and monitoring.</li><li>Identify opportunities for contract consolidation and renegotiation to optimize cost and service delivery.</li><li>Support and recommend KPIs for transformation success (e.g., cost efficiency, speed-to-market).and recommend objectives and key results for stakeholders.</li><li>Analyze data to pinpoint issues, assess risks, and make data-driven decisions.</li><li>Participate in, adhere to, and support compliance, people and culture, and learning programs.</li><li>Perform other duties as assigned.</li></ul>
Qualifications:
<div>
Essential Background Requirements:</div><div></div><div><br>
Education: Bachelor&rsquo;s degree in business administration, supply chain, operations management, or other directly applicable field or equivalent education/experience. Procurement certification, MBA or advanced degree preferred.</div><div></div><div><br>
Experience:
<br>
o 8+ years of experience in procurement, vendor management, contract management, and strategic sourcing preferably within a regulated industry.<br>
o Strong knowledge of contract requirements, SLA development, and risk management frameworks.<br>
o Proven ability to lead cross-functional teams and influence senior stakeholders.<br>
o Exceptional negotiation, analytical, and communication skills.<br>
o Proven experience with services and products using artificial intelligence and progressive technologies</div><div></div><div><br>
#LI-Remote</div>
Location : Address: Remote Location : Country: US</div>

Strategic Sourcing IT Contracting Lead

<div>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 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._____________________________________________________________________________________________________________________________________________________________________________________________________________. Current associates must use SSO login option at https://employees-navitus.icims.com/ to be considered for internal opportunities. Pay Range: USD $20.00 - USD $23.06 /Hr. STAR Bonus % (At Risk Maximum): 0.00 - Ineligible Work Schedule Description (e.g. M-F 8am to 5pm): M-F 8am to 5pm Remote Work Notification: ATTENTION: Navitus is 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. Overview:
<div>
Navitus Health Solutions is seeking an Analyst, Benefit Configuration to join our team!</div><div></div><div><br>
The Analyst, Benefit Configuration ensures efforts are in alignment with the Claim Adjudication Operations (CAO) team to leverage technology and process improvement for the purpose of meeting the business needs of Navitus customers, clients, members, and pharmacies by accurately administering benefits. The Analyst, Benefit Configuration configures benefits in the claim adjudication system based on specifications from internal customers and external clients. This role applies knowledge of highly diverse plan designs, formularies, and networks across multiple lines of business, ensuring that claims adjudicate accurately and timely.</div><div></div><div><br>
This position may include after-hour and/or weekend hours with other eligible team members depending on workload.</div><div></div><div><br>
Is this you? Find out more below!</div>
Responsibilities:
<div><b>
How do I make an impact on my team?</b></div><ul><li>
Completes scheduled and urgent benefit additions, terminations, and changes timely and accurately to prevent member access to care issues, missed performance guarantees and potential liquidated damages.</li><li>
Acquires and maintains a basic level of knowledge and interpretation of multiple adjudication system screens and functions on a field-by-field level to design both standard and custom configurations to meet client expectations.</li><li>
Complies with standards set forth regarding benefit design and configuration including HIPAA, NCPDP and Navitus internal business standards.</li><li>
Performs quality assurance peer reviews and uses sound business judgment and expertise to contribute toward the creation of root cause analysis of issues.</li><li>
Uses departmental workflow management, issue resolution and reporting tools for troubleshooting and responding to general customer questions and issue resolution requests.</li><li>
Supports internal customers by participating in client meetings, audits and new program implementations with other areas of the company, answering benefit setup questions and providing guidance to other areas and roles on the benefit configuration process.</li><li>
Adapts to industry changes and evolving technology, maintaining a basic level of understanding of both legacy and emerging products and systems.</li><li>
Independently assesses business needs and participates in process improvement, cost reduction and automation efforts.</li><li>
Contributes to the creation and ongoing maintenance of departmental training materials, work instructions and policies.</li><li>
Conducts system enhancement and regression testing of a low to moderate level of complexity for benefit configuration processes to ensure compliance with state, federal and client regulations/standards.</li><li>
Contributes to training and maintains a mentoring relationship with new and existing benefit configuration team members.</li><li>
Participate in, adhere to and support compliance and diversity, equity, and inclusion program objectives.</li><li>
Other duties as assigned.</li></ul>
Qualifications:
<div><b>
What our team expects from you?
</b></div><ul><li>Associate&rsquo;s degree or equivalent work experience required</li><li>
Minimal experience and/or training to begin learning skills, systems, and processes of the role with ability to perform tasks with close supervision</li><li>
Basic experience with Microsoft Office, specifically Word and Excel</li><li>
Participate in, adhere to, and support compliance program objectives</li><li>
The ability to consistently interact cooperatively and respectfully with other employees</li></ul><p></p><div><p><b><br>
What can you expect from Navitus?</b></p><ul><li>
Top of the industry benefits for Health, Dental, and Vision insurance</li><li>
20 days paid time off</li><li>
4 weeks paid parental leave</li><li>
9 paid holidays</li><li>
401K company match of up to 5% - No vesting requirement</li><li>
Adoption Assistance Program</li><li>
Flexible Spending Account</li><li>
Educational Assistance Plan and Professional Membership assistance</li><li>
Referral Bonus Program &ndash; up to $750!</li></ul><div></div><div><div><div>
#LI-Remote</div></div></div></div>
Location : Address: Remote Location : Country: US</div>

Analyst, Benefit Configuration

Join Navitus Health Solutions / Lumicera Health Services and explore 2   exciting career opportunities. They're hiring for various roles with options for remote or on-site work. Apply today and become part of their innovative team.

Navitus Health Solutions / Lumicera Health Services

About Company

Strategic Sourcing IT Contracting Lead

Analyst, Benefit Configuration