Specialist II, Pharmacy Relations

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) 7.50 - 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 only able to offer remote work to 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, Wisconsin. 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 reviewsReview pharmacy contract setup to ensure compliance with pharmacy network agreementsSupport pharmacy audits and network compliance initiativesResearch and problem solve to resolve claim issues and concernsRespond to and track requests, inquiries, and communications with network pharmaciesDevelop, review, and distribute pharmacy communications to meet internal and client requestsMonitor, track, and report pharmacy compliance with guiding government regulations and internal policies and proceduresReviews and responds to independent pharmacy redlines; with little to no input from senior leadershipResponsible for all aspects of maintenance related to pharmacy network functions, such as, network plan design builds, quality assurance measures and claims processing in generalOther 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 plusCertified Pharmacy Technician preferred3 years business-setting experienceRetail pharmacy experience or experience in a managed care pharmacy setting desiredPrior experience analyzing medical and/or pharmacy claims or credentials are highly desired Proficient in Microsoft Office and industry related softwareParticipate in, adhere to, and support compliance program objectivesThe 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 insurance20 days paid time off4 weeks paid parental leave9 paid holidays401K company match of up to 5% - No vesting requirementAdoption Assistance ProgramFlexible Spending AccountEducational Assistance Plan and Professional Membership assistanceReferral Bonus Program – up to $750! Location : Address Remote Location : Country US