Director, Pharmacy Network Pricing & Market Planning

Embedded Shishya; Deutschland; Remote; EUR 123.000 - 153.000; Vollzeit

Benefits dieser Stelle

Health insurance

Paid time off

Parental leave

401K match

Zusammenfassung

Navitus is seeking a Director, Network Pricing & Market Planning to own pharmacy network financial performance across all lines of business. You will ensure contracted rates are realized, lead reconciliation, and drive price governance with cross-functional teams.

Responsibilities include overseeing MAC pricing, monitoring reimbursement performance, and implementing corrective actions to meet contractual goals. Strong leadership and pricing analytics are required.

Qualifikationen

• Bachelor’s degree in Business, Finance, Economics, or Healthcare Administration, or related field, or equivalent work experience.
• 7+ years of progressive PBM, healthcare plan, pharmacy network, or related experience.
• 3+ years of leadership experience delivering results in professional services.
• Experience in pricing strategy, market analysis, or network planning.
• Experience supporting RFP pricing and competitive market analysis.
• Prior matrix-management experience preferred.
• Participate in and support compliance program objectives.

Aufgaben

• Lead Network Reconciliation with accountability for validating performance against contracted rates and guarantees.
• Own reconciliation outcomes across all lines of business and ensure accurate settlements.
• Establish processes to monitor, measure, and report network performance vs targets.
• Identify variances and drive corrective actions with Contracting and Pricing teams.
• Provide governance across reconciliation activities and audit readiness.
• Oversee pricing constructs (BER/GER, MAC, NADAC, PAC, AWP) to align with contracts.
• Lead the MAC Pricing team and maintain enterprise MAC pricing.
• Monitor claim-level reimbursement to identify outliers and inefficiencies.

Kenntnisse

Pricing strategy

Market analysis

Network planning

Leadership

RFP pricing

Matrix management

Compliance

Ausbildung

Bachelor’s degree in Business/Finance/Economics/Healthcare Admin

Jobbeschreibung

Company NavitusAbout 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 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 $142,128.00 - USD $177,660.00 /Yr.STAR Bonus % (At Risk Maximum)

15.00 - Director, GM of GP, PICWork Schedule Description (e.g. M-F 8am to 5pm)

M-F 8am-5pmRemote 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

Due to growth, we are adding a Director, Network Pricing & Market Planning to our team!

The Director, Network Pricing & Market Planning is responsible for owning pharmacy network financial performance across all lines of business, with direct accountability for achieving contracted reimbursement guarantees, including effective rate (BER/GER) performance and MAC pricing outcomes. This role leads the Network Reconciliation and MAC Pricing teams and is accountable for ensuring that contracted pharmacy rates are operationalized, monitored, and achieved. The Director focuses on performance execution—translating network pricing strategies into realized financial outcomes through rigorous reconciliation, variance management, and pricing intervention.

The Director partners with Network Contracting, Underwriting, Finance, and Analytics leadership to ensure alignment between contracted terms and financial outcomes. Unlike strategy or informatics roles, this position is accountable for post-contract performance realization—owning the processes, teams, and controls that ensure pharmacy reimbursement aligns with contractual expectations. This includes reconciliation oversight, effective rate compliance, MAC performance, and corrective action when performance deviates.

Is this you? Find out more below!

Responsibilities

Network Performance Ownership & Reconciliation Leadership

• Lead the Network Reconciliation function with full accountability for validating pharmacy network performance against contracted effective rates (BER/GER) and pricing guarantees.
• Own reconciliation outcomes across all lines of business, ensuring accurate financial settlement and alignment to contract terms.
• Establish and enforce processes to monitor, measure, and report on network performance vs. contractual targets (e.g., AWP discounts, effective rate thresholds).Identify performance variances and drive corrective actions in partnership with Network Contracting and Pricing teams.
• Insure audit readiness, financial transparency, and governance across all reconciliation activities.
• Provide oversight of pharmacy network performance across all pricing constructs (e.g., effective rate, MAC, NADAC, PAC, flat AWP), ensuring reported outcomes align with contracted reimbursement intent, even where pricing methodologies are managed outside of this function.

MAC Pricing Strategy Execution & Governance

• Lead the MAC Pricing team with accountability for development, maintenance, and performance of enterprise MAC pricing.
• Ensure MAC pricing effectively supports achievement of contracted effective rates and overall network financial targets.
• Oversee ongoing monitoring of claim‑level reimbursement performance to identify outliers and pricing inefficiencies.
• Drive timely MAC adjustments to address performance gaps, market changes, and provider behavior.Establish governance and controls to ensure MAC pricing is competitive, compliant, and aligned with enterprise financial goals.

Qualifications

What our team expects from you?

• Bachelor’s degree in Business, Finance, Economics, or Healthcare Administration, or related field, or equivalent work experience, required.
• 7+ years of progressive PBM, healthcare plan, pharmacy network, or related experience required.
• 3+ years of leadership experience with a proven ability to develop high‑performing teams and deliver tangible results in a professional services environment required.
• Demonstrated experience in pricing strategy, market analysis, or network planning required.
• Experience supporting RFP pricing and competitive market analysis required.
• Prior experience leading or matrix‑management experience preferred.
• 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

RemoteLocation : Country

US