Network Management Analyst

Key Responsibilities

• Investigate and resolve pharmacy contract non-compliance allegations, including complex and sensitive cases
• Conduct outreach to pharmacies to gather information and address identified issues
• Analyze claims data and adjudication results to support findings and recommendations
• Partner with Sales, Account Management, and other internal teams to coordinate resolution efforts
• Prepare detailed written responses for plan sponsors, participants, and internal stakeholders
• Address and resolve customer concerns related to network pharmacy performance
• Maintain thorough documentation of investigations and outcomes
• Manage multiple cases simultaneously while meeting deadlines and maintaining accuracy

Required Qualifications

• 3+ years of retail pharmacy experience
• 2+ years of claims adjudication research experience
• 2+ years of experience with Microsoft Office applications (Excel, Outlook, Word)
• Bachelor’s degree required

Preferred Qualifications

• 2+ years of Pharmacy Benefit Management (PBM) experience
• Experience contacting pharmacies and managing challenging or escalated conversations
• Strong knowledge of pharmacy operating systems and claims adjudication software
• Excellent oral and written communication skills with strong attention to detail
• Demonstrated critical thinking and analytical skills
• Strong organizational and time management skills
• Self-motivated, assertive, and able to make independent decisions