Navitus Health SolutionsNS

Reimbursement Analyst, Pharmacy Network

Navitus Health Solutions is a pharmacy benefit manager (PBM) founded in 2003 with a mission to make prescription medications more affordable through a transparent, 100% pass-through model. They serve nearly 18 million members across almost 800 clients.

Navitus Health Solutions

Employee count: 1001-5000

Salary: 53k-63k USD

United States only

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.

Pay Range

USD $52,656.47 - USD $62,686.28 /Yr.

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

M-F 8am to 5pm CT

Remote Work Notification

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

Overview

Navitus Health Solutions is seeking a Reimbursement Analyst, Pharmacy Network to join our Provider Services department!

The Analyst supports and evaluates agreements with providers and the Maximum Allowable Cost (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!

Responsibilities

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
  • 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
  • Research customer and contract issues that may affect account planning, strategies, and proposals. Assists with RFP responses as necessary
  • Periodic and detailed reporting of activities and opportunities to Provider Services team and cross-functional leadership
  • Research external and internal pricing trends and opportunities to contribute to overall pricing strategy
  • Perform 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
  • Other duties as assigned

Qualifications

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
  • 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!

Location : Address

Remote

Location : Country

US

About the job

Apply before

Posted on

Job type

Full Time

Experience level

Entry-level
Mid-level

Salary

Salary: 53k-63k USD

Location requirements

Hiring timezones

United States +/- 0 hours

About Navitus Health Solutions

Learn more about Navitus Health Solutions and their company culture.

View company profile

We are Navitus Health Solutions, and for more than two decades, we've been dedicated to transforming the pharmacy benefit management (PBM) landscape. Founded in 2003, our core belief was that the traditional PBM model needed a fundamental shift to better serve the interests of plan sponsors and their members. This conviction led us to pioneer a 100% pass-through business model, a transparent approach designed to eliminate unnecessary costs and ensure that all negotiated rebates, discounts, and fees are returned directly to our clients. We're driven by a profound commitment to helping people access the medications they need at more affordable prices, ultimately enabling them to lead fuller lives.

Our journey began with a vision to disrupt the industry norms and establish a new standard for financial and operational transparency in pharmacy benefits. We're proud to have consistently upheld this unique model, which stands in contrast to other established PBMs. Our purpose is clear: to humanize the pharmacy benefit experience and to relentlessly pursue strategies that lower overall drug spend and the cost of care. We achieve this by providing full financial and operational disclosures, improving medication adherence, and offering alternative treatment options that can reduce long-term drug reliance. We proudly serve almost 18 million members through nearly 800 clients, a testament to the trust placed in our approach. Our mission is to make medications more affordable for those who need them, fostering a healthcare system where honesty and open communication build unwavering trust.

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Navitus Health Solutions

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