Director, Network Pricing & Market Strategy - Remote

Navitus; Atlanta (GA); Remote; USD 180,000 - 270,000; Full time

Benefits offered by this job

Health benefits

Paid time off

Parental leave

Holidays

401K match up to 5%

Adoption Assistance

Flexible Spending Account

Educational Assistance

Referral Bonus up to $750

Job summary

Navitus Health Solutions seeks an experienced Director to lead Network Pricing & Market Planning, owning pharmacy network financial performance across all lines of business and achieving contracted reimbursement guarantees.

The role guides reconciliation, MAC pricing governance, and pricing interventions, collaborating with Network Contracting, Underwriting, Finance, and Analytics to ensure post-contract performance aligns with terms and delivers measurable financial outcomes.

Qualifications

• Bachelor’s degree in Business, Finance, Economics, or Healthcare Administration, or equivalent.
• 7+ years PBM/healthcare network experience.
• 3+ years in leadership developing high-performing teams.
• Experience in pricing strategy, market analysis, or network planning.
• Experience supporting RFP pricing and competitive market analysis.
• Prior matrix-management experience preferred.
• Participation in compliance program objectives.
• Ability to interact cooperatively with colleagues.

Responsibilities

• 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, ensuring accurate financial settlement.
• Monitor performance vs. contractual targets and drive corrective actions with partners.
• Ensure audit readiness, financial transparency, and governance across reconciliation activities.
• Provide oversight of network performance across pricing constructs (BER/GER, MAC, NADAC, PAC, AWP).
• Oversee MAC pricing development, maintenance, and performance to meet targets.
• Establish governance and controls to keep MAC pricing competitive and compliant.

Skills

PBM expertise

Pricing governance

Reimbursement analytics

MAC pricing

Leadership

Contracting alignment

Education

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

Job description

Navitus Health Solutions seeks an experienced Director to lead Network Pricing & Market Planning, owning pharmacy network financial performance across all lines of business and achieving contracted reimbursement guarantees.

The role guides reconciliation, MAC pricing governance, and pricing interventions, collaborating with Network Contracting, Underwriting, Finance, and Analytics to ensure post-contract performance aligns with terms and delivers measurable financial outcomes.