Director, Network Pricing & MAC Strategy (Remote)

Navitus; Jefferson City (MO); Remote; USD 150.000 - 230.000; Vollzeit

Benefits dieser Stelle

Health insurance

20 days paid time off

4 weeks paid parental leave

9 paid holidays

401K company match

Adoption Assistance Program

Flexible Spending Account

Educational Assistance Plan

Referral Bonus Program

Zusammenfassung

Navitus Health Solutions is seeking a Director, Network Pricing & Market Planning to lead network pricing performance across all lines of business, including BER/GER and MAC pricing. This role oversees Network Reconciliation and MAC Pricing teams to ensure contracted terms translate into measurable financial outcomes.

The ideal candidate has deep PBM expertise, strong reimbursement analytics, and a proven track record turning complex pricing structures into financial performance.

Qualifikationen

• 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.

Aufgaben

• Lead the Network Reconciliation function with accountability for validating network performance against contracted rates and pricing guarantees.
• Own reconciliation outcomes across all lines of business and ensure accurate financial settlement.
• Monitor, measure, and report network performance vs contractual targets; drive corrective actions with Contracting and Pricing teams.
• Provide governance across reconciliation activities and ensure audit readiness and transparency.
• Oversee MAC Pricing governance, development, and performance to achieve contracted rates and financial targets.

Kenntnisse

PBM expertise

Pricing governance

Leadership

Healthcare analytics

Ausbildung

Bachelor's degree in Business, Finance, Economics or Healthcare Administration

Jobbeschreibung

Navitus Health Solutions is seeking a Director, Network Pricing & Market Planning to lead network pricing performance across all lines of business, including BER/GER and MAC pricing. This role oversees Network Reconciliation and MAC Pricing teams to ensure contracted terms translate into measurable financial outcomes.

The ideal candidate has deep PBM expertise, strong reimbursement analytics, and a proven track record turning complex pricing structures into financial performance.