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 $65,686.00 - USD $79,140.00 /Yr. STAR Bonus % (At Risk Maximum) 5.00 - Salaried Non-Management except pharmacists Work Schedule Description (e.g. M-F 8am to 5pm) M-F 8am to 5pm CT 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 Due to growth, we are adding a Claims Quality Assurance Specialist to our team. The Claims Quality Assurance Specialist ensures the accuracy and integrity of pharmacy benefit configurations through comprehensive audit and testing activities. This role performs recurring monthly quality validations for assigned clients, including test preparation, scenario design, adjudication testing, and detailed result analysis across multiple environments. The Specialist applies expertise in diverse plan designs and benefit structures across Commercial, Exchange, Medicaid, and Medicare Part D lines of business while collaborating closely with cross functional teams. The role requires strong analytical skills, attention to detail, adaptability to ongoing system and industry changes, and occasional after hours or weekend support based on testing demands. Is this you? Find out more below! Responsibilities How do I make an impact on my team? - Execute monthly quality assurance testing cycles, including client group selection, high utilization drug identification, test member preparation, adjudication file execution, results import, analysis, and month over month comparison. - Validate adjudication results against plan grids, formularies, configuration documents, and other sources of truth; prepare QA deliverables and submit discrepancies for resolution. - Design comprehensive test scenarios using live claim sampling, client issue history, and financially impactful drug categories to ensure adequate coverage. - Develop and apply working knowledge of Navitus audit methodologies and end to end pharmacy benefit workflows to identify quality risks and downstream impacts. - Identify, document, track, and retest defects as fixes are applied; support root cause analysis and resolution efforts. - Perform peer reviews and quality checks to ensure adherence to audit criteria, validation standards, and business rules. - Utilize QA and workflow tools (e.g., Qlik Sense, RxFlex, FBMS) to troubleshoot and resolve moderately complex adjudication and configuration issues. - Maintain an intermediate understanding of adjudication systems, testing environments, and quality assurance methodologies. - Participate in process improvement initiatives, documentation updates, training material development, automation efforts, and standardization activities. - Other duties as assigned. Qualifications What our team expects from you? - Bachelor’s degree or equivalent work experience is required. - Pharmacy Technician License or National Certification preferred. - 5+ years of experience in quality assurance, benefit configuration, or data validation roles within a pharmacy benefit management (PBM) or similar payer environment required. - Experience supporting clients in all lines of business of varying size and complexity preferred. - Intermediate proficiency required in Microsoft Office (Excel, Word, PowerPoint), QlikView/Qlik Sense or comparable reporting tools, formulary management applications, request management platforms (ConnectUs, Service Desk, Jira, ServiceNow), and PBM adjudication or configuration systems (e.g., Navi ClaimRx). - Prior experience with data analysis, defect tracking, or root cause analysis within a healthcare environment preferred. - 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? - 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! #LI-Remote Location : Address Remote Location : Country US

• Drive quality for assigned suppliers, including quality plan implementation • Select suppliers through qualification processes • Own supplier results, drive improvements utilizing supplier scorecards • Own supplier audits, ensuring compliance, and driving improvement plans where needed • Collaborate with internal teams to escalate complex issues

Come join our amazing team and work remote from home! The Default FHA Claims QA Analyst II will work under moderate supervision, responsible for reviewing FHA mortgage insurance claims for accuracy and submitting the claim form for filing. Performs all duties in accordance with the company’s policies and procedures and all US state and federal laws and regulations wherein the company operates. The target pay for this position is $24.50/hr - $26.00/hr. What you’ll do: - Review FHA claims for accuracy within the investor/insurer timeframes. - Complete quality checks using a scorecard and/or checklist to identify errors in the claim. - Communicate correction requests to claim filing team and ensure corrections are completed accurately and timely. - Document system with appropriate tasking and comments. - Ensure accurate dates and information are recorded on the FHA claim form. - Validate that all expenses within the system have been reconciled and claimed in accordance with agency requirements. - Ensure company procedures around the curtailment of advances are followed and enforced. - Ensure required documentation is included in the Claim File and/or uploaded to agency website according to FHA guidelines. - Finalize and submit claim to agency for payment. - Escalate trends or issues identified from the quality review. - Moderate knowledge of default claims processes for insurers and investors. - Understanding of the default servicing process, to include Foreclosure, Bankruptcy, Loss Mitigation and Claims process. - Moderate understanding of Agency and investor guidelines. - Strong interpersonal skills with a focus on teamwork and quality. - Excellent written and oral communication, organizational and time management skills. - Ability to communicate effectively with all levels of staff and management both internally and externally. - Ability to manage work in order to meet strict deadlines. - Ability to handle multiple tasks under pressure and changing priorities. What you’ll need: - High School diploma required; some college preferred. - Two (2) or more years’ mortgage servicing default experience, or QA/QC experience in another line of business. Our Company: Carrington Mortgage Services is part of The Carrington Companies, which provide integrated, full-lifecycle mortgage loan servicing assistance to borrowers and investors, delivering exceptional customer care and programs that support borrowers and their homeownership experience. We hope you’ll consider joining our growing team of uniquely talented professionals as we transform residential real estate. To read more visit: www.carringtonmortgage.com. What We Offer: - Comprehensive healthcare plans for you and your family. Plus, a discretionary 401(k) match of 50% of the first 4% of pay contributed. - Access to several fitness, restaurant, retail (and more!) discounts through our employee portal. - Customized training programs to help you advance your career. - Employee referral bonuses so you’ll get paid to help Carrington and Vylla grow. - Educational Reimbursement. - Carrington Charitable Foundation contributes to the community through causes that reflect the interests of Carrington Associates. For more information about Carrington Charitable Foundation, and the organizations and programs, it supports through specific fundraising efforts, please visit: carringtoncf.org. Notice to all applicants: Carrington does not do interviews or make offers via text or chat. #LI-SY1

• Validate and ensure the quality of product lifecycle management solutions • Design and execute test cases • Perform functional, integration, and regression testing • Verify workflows, data models, and system configurations within Teamcenter • Collaborate with developers, business analysts, and stakeholders to identify defects • Ensure requirements traceability • Support end-to-end testing of PLM processes