Network Contracting Analyst

Emploi pas sur LinkedIn

🕒 il y a 6 mois

🇺🇸 États-Unis – Télétravail

💵 $54 236 - $64 566 / an

⏰ Temps Plein

🟢 Junior

🧐 Analyste

🚫👨‍🎓 Aucun diplôme requis

👻 Score fantôme 45%

infoinfo

🗣️🇺🇸🇬🇧 Anglais requis

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Logo of Navitus Health Solutions

Navitus Health Solutions

1001 - 5000 employés

Fondée en 2003

💼 Conseil

🛡️ Assurance

🏥 Santé

Consulting • Insurance • Healthcare

Navitus Health Solutions est un gestionnaire de prestations pharmaceutiques (PBM) qui propose des solutions transparentes et centrées sur les personnes pour les prestations pharmaceutiques, à destination des régimes de santé, des employeurs, des programmes gouvernementaux et d'autres parrains de régimes. L'entreprise opère sur un modèle de passage intégral à un coût majoré, qui met l'accent sur la réduction des coûts des médicaments, la gestion des formulaires, la gestion des médicaments spécialisés (y compris une pharmacie spécialisée à coût majoré), l'évaluation des réclamations, la gestion du réseau de pharmacies, ainsi que l'activation et le support des membres. Navitus se positionne comme un partenaire fiduciaire axé sur l'accessibilité, la conformité, la qualité clinique, et l'amélioration des résultats de santé grâce à des services PBM sur mesure et à des intégrations de santé numérique.

Description

• Support the network contracting management division by preparing contracting and strategy analytics, including new contracts and contract renewals • Prepare analyses covering provider agreements, 340B opportunities, mail order, discount card, specialty, and related needs • Complete complex analysis to monitor the value of contracts and strategic initiatives • Prepare forward-looking network analytics aligned with planned actions, targets, and forecasts • Monitor industry trends including acquisition cost, competitive intelligence, and innovative program offerings • Support quarterly forecasting, annual planning, and multi-year contracting development and financial modeling • Advise internal stakeholders on strategic fiscal matters related to pharmacy financial management • Participate in leadership meetings to review financial results, interpret results, analyze variances, and improve contracting performance • Support pharmacy contract negotiations by monitoring and delivering impact analysis of pricing revisions • Develop work plans to meet provider and client priorities and deadlines • Collaborate cross-functionally, escalate high-priority issues and risks, and identify network management improvement opportunities • Communicate updated network pricing and network design changes with the Pharmacy Network Analytics team • Perform other duties as assigned

🎯 Exigences

• Bachelor’s degree in finance, accounting, business, actuarial science or related field is preferred • At least one year of database management experience • Experience in business, finance, or analytics • Experience in Retail Pharmacy and/or Pharmacy Benefit Management (PBM) or Managed Care preferred • Familiarity with the Pharmacy Benefit Management (PBM), contracting and pharmacy industry/technical terms, pricing and processes preferred • Experience with CMS, Medicare, and state Medicaid regulations and guidance preferred • Knowledge of health care processes and pharmaceutical claims adjudication systems preferred • Participate in, adhere to, and support compliance program objectives • Ability to consistently interact cooperatively and respectfully with other employees

🏖️ Avantages

• 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!

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