Director, Network Pricing & Market Planning (Remote)

Navitus; Richmond (VA); Remote; USD 180,000 - 260,000; Full time

Benefits offered by this job

Health insurance

PTO 20 days

Parental leave 4 weeks

9 paid holidays

401K match up to 5%

Adoption Assistance

Flexible Spending Account

Educational Assistance Plan and Memb.​

Referral Bonus up to $750

Job summary

Navitus Health Solutions, a leader in Pharmacy Benefit Management, seeks an experienced Director of Network Pricing & Market Planning in a remote-friendly US role. The role owns network financial performance, reimbursement guarantees, MAC pricing outcomes, and governance across all lines of business.

The position leads Network Reconciliation and MAC Pricing teams, translating pricing strategies into realized financial results with robust reconciliation and variance management.

Qualifications

• 7+ years in PBM, healthcare plan, or pharmacy network roles with progression.
• 3+ years of leadership experience building high-performing teams.
• Proven pricing strategy, market analysis, or network planning experience.
• Experience supporting RFP pricing and competitive market analysis.
• Matrix-management experience preferred.

Responsibilities

• Own network performance and reconciliation across all lines of business to meet contracted rates and pricing guarantees.
• Lead MAC pricing strategy, governance, and ongoing claim-level performance monitoring.
• Drive timely MAC adjustments and address market/provider changes.
• Ensure audit readiness, financial transparency, and governance of reconciliation activities.
• Collaborate with Network Contracting, Underwriting, Finance, and Analytics to align terms with outcomes.

Skills

PBM pricing

Leadership

Pricing strategy

Reimbursement analytics

Contracting experience

Stakeholder collaboration

Education

Bachelor's degree in Business/Finance/Healthcare Administration

Tools

Pricing analytics tools

Excel

Job description

Navitus Health Solutions, a leader in Pharmacy Benefit Management, seeks an experienced Director of Network Pricing & Market Planning in a remote-friendly US role. The role owns network financial performance, reimbursement guarantees, MAC pricing outcomes, and governance across all lines of business.

The position leads Network Reconciliation and MAC Pricing teams, translating pricing strategies into realized financial results with robust reconciliation and variance management.