Accounting, Actuarial Skills, Adjudication Systems, Analysis Skills, Analytical Development, Biotech and Pharmaceutical, Centers for Medicare and Medicaid Services (CMS), Claims Processing, Compensation and Benefits, Contract Analysis, Contract Management, Contract Negotiation, Cross-Functional, Customer Support/Service, Database Administration, Diversity, Finance, Financial Analysis, Financial Management, Financial Modeling, Financial Strategy, Forecasting, Healthcare, Industry/Trade Analysis, Intel Product Family, Managed Care, Medicaid, Medicare, Medications, Network Administration/Management, Network Performance/Analysis, Network Support, Pharmacy, Pricing, Reimbursement, Retail, Retail Management, Risk, Risk Management, State Laws and Regulations, Strategic Analysis, Strategic Planning, Supply Chain, Work From Home
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.
Current Associate Information
Current associates must use SSO login option at https://employees-navitus.icims.com/ to be considered for internal opportunities.
Pay Range
USD $52,656.00 - USD $62,686.00 /Yr.
STAR Bonus % (At Risk Maximum)
5.00
Salaried Non-Management except pharmacists
Work Schedule Description (e.g. M-F 8am to 5pm)
M-F 8am-5pm, CT
Remote Work Notification
ATTENTION: Navitus is 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.
Overview
Navitus Health Solutions is seeking a Network Contracting Analyst to join our team! The Analyst, Network Contracting will be responsible for the financial management of retail, specialty, and mail order pharmacy contracting, issue management, and reporting, in support of the network strategy to deliver value to Navitus clients.
Responsibilities
- Analyze current and new pharmacy contracts and provide support for all phases of the pharmacy contracting process, including national and regional chain providers, pharmacy services administration organizations (PSAOs) and independent pharmacies for all lines of business.
- Analyze contract alternatives to support Network Contracting retail and specialty teams and lead analysis of negotiated contracts to maximize return and mitigate risks.
- Provide clear data summaries to explain reimbursement, network needs, and industry trends to support pharmacy and vendor contract negotiations across all lines of business and geographies (Commercial, Medicare and managed Medicaid).
- Work cross functionally with internal and external partners including clients, vendors, and pharmacy partners to deliver value to Navitus clients through our pharmacy contracts.
How to Make an Impact on Your Team
- Prepare contracting and strategy analytics, including new contracts and contract renewals.
- Complete complex analysis to monitor the value of contracts and strategic initiatives of Navitus.
- Prepare forward-looking network analytics, ensuring alignment of planned actions and targets in the forecast.
- Proactively monitor industry trends including acquisition cost, competitive intel, and innovative program offerings.
- Support network management leaders in the development and analytical review of quarterly forecasting, annual planning, and multi-year contracting development and multi-year financial modeling.
- Advise internal stakeholders on strategic fiscal matters related to pharmacy financial management throughout the organization.
Qualifications
- Bachelor's degree in finance, accounting, business, actuarial science or related field is preferred.
- At least one year of database management experience.
- Experience in business, finance, or analytics.
- Experience in Retail Pharmacy and/or Pharmacy Benefit Management (PBM) or Managed Care preferred.
- Familiarity with the Pharmacy Benefit Management (PBM), contracting and pharmacy industry/technical terms, pricing and processes preferred.
- Experience with CMS, Medicare, and state Medicaid regulations and guidance preferred.
- Knowledge of health care processes and pharmaceutical claims adjudication systems preferred.
What We Expect from You
- Participate in, adhere to, and support compliance program objectives.
- The ability to consistently interact cooperatively and respectfully with other employees.
What You Can 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
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Navitus Health Solutions LLC