Reimbursement Analyst, Pharmacy Network-Remote

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.

Due to growth, we are adding this Reimbursement Analyst, Pharmacy Network to our Pharmacy Network Contracting department.

We are 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.

The Reimbursement Analyst, Pharmacy Network is responsible for the operation of the Navitus Maximum Allowable Cost (MAC) pricing program and other generic and brand reimbursement systems with pharmacy providers. The objective is to achieve market leading discounts, fair reimbursement to providers, and to ensure maximum competitive pricing is attained.

The Analyst supports and evaluates agreements with providers and the MAC program through financial price modeling, analysis, and reporting. This position will communicate and work cross functionally with other teams on generic trends and generic drug discount change effects. Provider and network performance will be analyzed in support of network development, contracting negotiations, and RFP proposals. The Analyst, under the direction and supervision of the Provider Services leadership, is responsible for maintaining a competitive and market leading MAC program. The Analyst will also be responsible for managing and responding to pharmacy pricing inquiries in compliance with Navitus response protocol. This position will help monitor and evaluate state MAC requirements to ensure Navitus remains compliant with MAC management and inquiry. The Analyst will assist in working with internal and external partners including pharmacies, clients, vendors, and internal department liaisons to implement and maintain an effective MAC program.

Is this you? Find out more below!

How do I make an impact on my team?

• Operation and timely administration of the Navitus generic pricing programs including MAC, NADAC, or other pricing structures, which includes determining products to be included on the MAC list and the associated price per unit and updating all pricing within Navitus systems.

• Responsible for fielding, analyzing, and resolving inquiries from pharmacy providers, clients, and internal teams.

• Understand, follow, and assist with improvements to current operational and administrative processes.

• Evaluate state MAC requirements to ensure Navitus MAC management remains compliant.

• Monitor industry events to determine availability of generic introduction to the marketplace and manage exclusivity timeline for newly introduced generics.

• 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, including analysis and communication of reimbursement activities.

• Make decisions regarding the resolution of pharmacy issues.

• Research customer and contract issues that may affect account planning, strategies, and proposals. Assists with RFP responses as necessary.

• Develop and execute effective communication vehicles to disseminate accurate and concise information to network providers.

• Other related duties as assigned/required.

What our team expects from you?

• Bachelor's degree required. Emphasis in business, finance, economics, or actuarial science strongly preferred. Recent college graduates are encouraged to apply.

• Detailed and well-organized, with both interpersonal and analytical skills, and can manage multiple priorities.

• Ability to retrieve and analyze large sets of data to aid in pricing decision making.

• Must be able to function independently while also working closely with individuals within other departments.

• Candidate must rely on knowledge of Navitus' business concepts, practices, and procedures to accomplish goals.

• Ability to prioritize work to meet a need.

• Excellent verbal and written communication as well as strong organizational skills.

• Able to take direction to meet departmental objectives.

• PC skills: Microsoft Excel, Access, and other applications as required.

• 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?

• Hours/Location: Monday-Friday 8am-5pm, CST-Remote

• Paid Volunteer Hours

• Educational Assistance Plan and Professional Membership assistance

• Referral Bonus Program - up to $750!

• Top of the industry benefits for Health, Dental, and Vision insurance, Flexible Spending Account, Paid Time Off, Nine paid holidays, 401K, Short-term and Long-term disability, College Savings Plan, Paid Parental Leave, Adoption Assistance Program, and Employee Assistance Program

#LI-Remote