Reimbursement Analyst, Pharmacy Network

🔥 1 hour ago

🐻 Alaska, Hawaii, +11 more states – Remote

🐻 Alaska – Remote 🌺 Hawaii – Remote 🦞 Maine – Remote 🗻 New Hampshire – Remote 🌶️ New Mexico – Remote 🌾 North Dakota – Remote 🎸 Mississippi – Remote ⚓ Rhode Island – Remote 🌴 South Carolina – Remote 🗿 South Dakota – Remote ⚔️ Virginia – Remote ⛰️ West Virginia – Remote 🦬 Wyoming – Remote

💵 $54.2k - $64.6k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🛜 Network Engineer / Network Administrator

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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

• 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. • Evaluate state MAC requirements to ensure Navitus MAC management remains compliant. • Monitor industry events to determine availability of generic introduction to the marketplace. • Manage consolidation of generic manufacturers in the market that will affect MAC pricing. • Continuously review and pro-actively identify areas of opportunities for pricing and discount performance improvement. • Research customer and contract issues that may affect account planning, strategies, and proposals. • Assist 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.

🎯 Requirements

• Bachelor’s degree required. Emphasis in business, finance, economics, or actuarial science strongly preferred. • Recent college graduates are encouraged to apply • Participate in, adhere to, and support compliance program objectives • The ability to consistently interact cooperatively and respectfully with other employees.

🏖️ Benefits

• 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!