Vice President, Government ProgramsAs Vice President of Government Programs, Carmen oversees the implementation, audit and monitoring, claims adjudication, technical operations and compliance with Medicare Part D, Medicaid and Exchange PBM service offerings. Carmen also manages the program and product development of PBM offerings for Medicaid FFS Pharmacy PBO contracts.
Prior to joining Navitus, Carmen served as Senior Vice President, Associated Financial Group as the account management, wellness and operational services leader. She also served as an executive of a 675,000-member regional PPO. Carmen began her career as a controller and operations leader for a consulting company, specializing in implementing operational models and technology solutions for start-up managed care organizations. She later transitioned into leadership roles within the IT division of an integrated healthcare entity, overseeing the delivery system and $4 million insurance software solutions for 160,000 member commercial and Medicaid HMO, and 160,000 member PPO.
Carmen holds a Bachelor of Arts degree in accounting and business administration, with an emphasis in computer science from Mount Marty College.
"Navitus’ commitment to high-quality and compliance ensures our clients remain in good standing with regulatory entities and contributes to our strong culture of transparency, passion and engagement, which is evidenced by our five consecutive years of maintaining the highest EGWP Star Ratings across all PBMs."