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Pharmacy Relations Specialist

Job not on LinkedIn

🔥 0 minutes ago

Where this job comes from

Posted on Navitus Health Solutions's careers page, not through a job board

First seen by Remote Rocketship 0 minutes ago

Logo of Navitus Health Solutions

Navitus Health Solutions

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

• Make decisions regarding the resolution of pharmacy issues • Establish and maintain contracts with pharmacy providers • Facilitate submittal, receipt, tracking, and process flow of contracts between Navitus and providers • Accurately enter information and maintain contract database • Generate reports on network performance to monitor claims accuracy throughout the terms of the contract • Create networks based on contract terms within the claims processing system and ensure accuracy by performing quality reviews • Assist in resolving intricate pharmacy provider issues and complaints • Coordinate pharmacy network communication efforts, including collecting content, disseminating information to provider partners through appropriate channels, and tracking response metrics • Perform other duties as assigned

🎯 Requirements

• At least 3 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 license preferred • 1-3 years of successful experience in a customer service role • Knowledge of PBM or health care industry preferred • PC skills: Microsoft Office, Email, Internet, and other applications as require • Participate in, adhere to, and support compliance program objectives • Ability to consistently interact cooperatively and respectfully with other employees • Residents of Alabama, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Florida, Georgia, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Montana, Nebraska, Nevada, New Jersey, New York, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, Tennessee, Texas, Utah, Vermont, Virginia, Washington, Washington DC, or Wisconsin

🏖️ 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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