Director, Network Pricing & Market Strategy (Remote)

Navitus; Topeka (KS); À distance; USD 160 000 - 210 000; Plein temps

Avantages offerts par ce poste

Health insurance

Dental insurance

Vision insurance

PTO 20 days

Parental leave 4 weeks

401K with match

Résumé du poste

Navitus Health Solutions seeks a Director who will own network pricing performance across all lines of business, drive MAC pricing and effective rate results, and translate pricing strategy into measurable financial outcomes.

You will lead the Network Reconciliation and MAC Pricing teams, ensure governance and compliance, and partner with Contracting, Underwriting, Finance, and Analytics to align terms with financial results.

Qualifications

• Bachelor’s degree in Business, Finance, Economics, 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.
• Pricing strategy, market analysis, or network planning experience.
• Experience supporting RFP pricing and competitive market analysis.
• Experience leading or matrix-management preferred.

Responsabilités

• Lead network reconciliation with accountability for validated performance against contracted rates and pricing guarantees.
• Own reconciliation outcomes across all lines of business, ensuring accurate financial settlements.
• Monitor, measure, and report network performance vs. targets (AWP discounts, rate thresholds).
• Ensure audit readiness, financial transparency, and governance across reconciliation activities.
• Oversee network pricing constructs (BER/GER, MAC, NADAC, PAC, flat AWP) and ensure alignment with reimbursement terms.

Connaissances

Pricing strategy

Market analysis

Network planning

Leadership

RFP pricing

Formation

Bachelor’s degree

Description du poste

Navitus Health Solutions seeks a Director who will own network pricing performance across all lines of business, drive MAC pricing and effective rate results, and translate pricing strategy into measurable financial outcomes.

You will lead the Network Reconciliation and MAC Pricing teams, ensure governance and compliance, and partner with Contracting, Underwriting, Finance, and Analytics to align terms with financial results.