Navitus Health Solutions

Specialist II, Pharmacy Relations

Navitus Health Solutions  •  $49k/yr  •  United States (Remote)  •  57 minutes ago
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Job Description

Company

Navitus

About Us

Navitus - Putting People First in Pharmacy - Navitus was founded as an alternative to traditional pharmacy benefit manager (PBM) models. We are committed to removing cost from the drug supply chain to make medications more affordable for the people who need them. At Navitus, our team members work in an environment that celebrates diversity, fosters creativity and encourages growth. We welcome new ideas and share a passion for excellent service to our customers and each other._____________________________________________________________________________________________________________________________________________________________________________________________________________. Current associates must use SSO login option at https://employees-navitus.icims.com/ to be considered for internal opportunities. ____________________________________________________We are committed to providing equal employment opportunity to all applicants and employees and comply with all applicable nondiscrimination regulations, including those related to protected veterans and individuals with disabilities. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, or handicap.

Pay Range

USD $48,728.61 - USD $58,010.26 /Yr.

STAR Bonus % (At Risk Maximum)

5.00 - Salaried Non-Management except pharmacists

Work Schedule Description (e.g. M-F 8am to 5pm)

M-F 8am to 5pm

Remote Work Notification

ATTENTION: Navitus is unable to offer remote work to residents of Alaska, Hawaii, Maine, Mississippi, New Hampshire, New Mexico, North Dakota, Rhode Island, South Carolina, South Dakota, West Virginia, and Wyoming.

Overview

Navitus Health Solutions is seeking a Pharmacy Relations Specialist to join our team!

The Pharmacy Relations Specialist (PRS II) is a highly motivated professional with at least 2 years of successful experience working in a pharmacy or interfacing directly with pharmacies or accounts, preferably in healthcare. Responsibilities include executing contracts with pharmacies, responding to pharmacy inquiries, and completing the tactical and operational tasks required to maintain contracted pharmacy networks.

Is this you? Find out more below!

Responsibilities

How do I make an impact on my team?

  • Manage pharmacy contracting process with independent pharmacies and select chains/PSAOs and assist management with network negotiations; inclusive of 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
  • Reviews and responds to independent pharmacy redlines; with little to no input from senior leadership
  • Responsible for all aspects of maintenance related to pharmacy network functions, such as, network plan design builds, quality assurance measures and claims processing in general
  • Other duties as assigned

Qualifications

What our team expects from you?

  • 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

What can you expect from Navitus?

  • 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!

#LI-Remote

Location : Address

Remote

Location : Country

US

Navitus Health Solutions

About Navitus Health Solutions

Navitus Health Solutions is a pioneering pharmacy solutions provider, having launched one of the first transparent PBMs over 20 years ago. Unlike traditional PBMs that profit from opaque pricing, Navitus passes 100% of negotiated rebates and discounts directly to health plans and plan sponsors. Its clinical model is built to manage spend from the start, making key decisions that support member health while lowering costs. This in turn drives both immediate value and long-term savings, by managing trend over time.

Navitus Health Solutions delivers a range of services through portfolio brands including Navitus, Lumicera and Archimedes. Owned by SSM Health and Costco Wholesale Corporation, the company serves over 18 million members across 800 clients, including public and private sector employers, unions, health plans and health systems. For more information, please visit www.navitus.com.

Industry
Healthcare & Social Services
Company Size
1,001-5,000 employees
Headquarters
Madison, WI
Year Founded
2003
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