Reimbursement Analyst, Pharmacy Network

Responsibilities

• Operation and timely administration of the Navitus generic pricing programs including MAC, NADAC, or other pricing structures.
• Determining products to be included on the MAC list and the associated price per unit and updating all pricing within Navitus systems.
• Fielding, analyzing, and resolving inquiries from pharmacy providers, clients, and internal teams.
• Evaluating state MAC requirements to ensure Navitus MAC management remains compliant.
• Maintaining a competitive and market leading MAC program.
• Managing and responding to pharmacy pricing inquiries in compliance with Navitus response protocol.
• Monitoring industry events to determine availability of generic introduction to the marketplace and managing exclusivity timelines for newly introduced generics.
• Continuously reviewing and pro-actively identifying areas of opportunities for pricing and discount performance improvement, including analysis and communication of reimbursement activities.
• Assisting with RFP responses as necessary.
• Periodic and detailed reporting of activities and opportunities to Provider Services team and cross-functional leadership.
• Researching external and internal pricing trends and opportunities to contribute to overall pricing strategy.
• Performing analyses as requested by internal and external business owners, or in support of identified business objectives, with special focus on pharmacy network profitability and/or client discounts.

Qualifications

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