Reimbursement Analyst, Pharmacy Network

🕒 il y a 2 mois

🥔 Idaho – Distant

🥔 Idaho – Remote

💵 $52 656 - $62 686 / an

⏰ Temps Plein

🟡 Intermédiaire

🟠 Senior

🧐 Analyste

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Navitus Health Solutions

Site WebLinkedInTous les Emplois

1001 - 5000 employés

Fondée en 2003

⚕️ Assurance santé

💊 Pharmaceutique

🤝 B2B

Healthcare Insurance • Pharmaceuticals • B2B

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

• Operation and timely administration of the Navitus generic pricing programs including MAC, NADAC, or other pricing structures • Responsible for fielding, analyzing, and resolving inquiries from pharmacy providers, clients, and internal teams • May evaluate state MAC requirements to ensure Navitus MAC management remains compliant • May manage quarterly and yearly pharmacy performance and/or reconciliations • Monitor industry events to determine availability of generic introduction to the marketplace and manage exclusivity timeline for newly introduced generics • Manage consolidation of generic manufacturers in the market that will affect MAC pricing • Continuously review and proactively identify areas of opportunities for pricing and discount performance improvement • Research customer and contract issues that may affect account planning, strategies, and proposals • Assists with RFP responses as necessary • Periodic and detailed reporting of activities and opportunities to Provider Services team and cross-functional leadership • Research external and internal pricing trends and opportunities to contribute to overall pricing strategy • Perform analyses as requested by internal and external business owners, or in support of identified business objectives, with special focus on pharmacy network profitability and/or client discounts • Participate in, adhere to and support compliance and diversity, equity, and inclusion program objectives • Other duties as assigned.

🎯 Exigences

• Bachelor’s degree required • Emphasis in business, finance, economics, or actuarial science strongly preferred • Experience in PBM or health care industry preferred • Participate in, adhere to, and support compliance program objectives • The 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!