Pharmacy Relations Specialist II

🔥 0 minutes ago

🏈 Alabama, Arizona, +34 more states – Remote

🏈 Alabama – Remote 🌵 Arizona – Remote 🏄 California – Remote ⛰️ Colorado – Remote 🦌 Connecticut – Remote 🏛️ District of Columbia – Remote 🐊 Florida – Remote 🥔 Idaho – Remote 🌽 Illinois – Remote 🌾 Iowa – Remote 🌪️ Kansas – Remote 🐎 Kentucky – Remote ⚜️ Louisiana – Remote 🦬 Montana – Remote 🌾 Nebraska – Remote 🎰 Nevada – Remote 🏖️ New Jersey – Remote 🗽 New York – Remote 🌲 North Carolina – Remote 🏈 Ohio – Remote 🌪️ Oklahoma – Remote 🌲 Oregon – Remote 🦀 Maryland – Remote 🍂 Massachusetts – Remote 🚗 Michigan – Remote ❄️ Minnesota – Remote 🏰 Missouri – Remote 🔔 Pennsylvania – Remote 🎸 Tennessee – Remote 🤠 Texas – Remote ⛷️ Utah – Remote 🍁 Vermont – Remote ⚔️ Virginia – Remote ☕ Washington – Remote 🧀 Wisconsin – Remote 🍑 Georgia – Remote

💵 $48.7k - $58k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

💊 Pharmacist

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Navitus Health Solutions

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 2003

💼 Consulting

🛡️ Insurance

🏥 Healthcare

Consulting • Insurance • Healthcare

Navitus Health Solutions is a pharmacy benefit manager (PBM) that provides transparent, people-centered pharmacy benefit solutions to health plans, employers, government programs and other plan sponsors. The company operates a 100% pass-through, cost-plus model that emphasizes lowering medication costs, managing formularies, specialty drug management (including a cost-plus specialty pharmacy), claims adjudication, pharmacy network management, and member enablement and support services. Navitus positions itself as a fiduciary partner focused on affordability, compliance, clinical quality and improving health outcomes through tailored PBM services and digital health integrations.

📋 Description

• Manage pharmacy contracting process with independent pharmacies and select chains/PSAOs and assist management with network negotiations, including redline reviews • Review pharmacy contract setup to ensure compliance with pharmacy network agreements • Support pharmacy audits and network compliance initiatives • Research and problem solve to resolve claim issues and concerns • Respond to and track requests, inquiries, and communications with network pharmacies • Develop, review, and distribute pharmacy communications to meet internal and client requests • Monitor, track, and report pharmacy compliance with guiding government regulations and internal policies and procedures • Review and respond to independent pharmacy redlines with little to no input from senior leadership • Maintain pharmacy network functions, including network plan design builds, quality assurance measures, and claims processing • Perform other duties as assigned

🎯 Requirements

• At least 2 years of successful experience working in a pharmacy or interfacing directly with pharmacies or accounts, preferably in healthcare • College or 2-year Technical Degree or equivalent experience is preferred • Advanced technical education a plus • Certified Pharmacy Technician preferred • 3 years business-setting experience • Retail pharmacy experience or experience in a managed care pharmacy setting desired • Prior experience analyzing medical and/or pharmacy claims or credentials are highly desired • Proficient in Microsoft Office and industry related software • Participate in, adhere to, and support compliance program objectives • The ability to consistently interact cooperatively and respectfully with other employees

🏖️ Benefits

• 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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