Director, PBM Network Pricing & Market Strategy (Remote)

Navitus; Lansing (MI); Remote; USD 180,000 - 260,000; Full time

Benefits offered by this job

Health insurance

Dental insurance

Vision insurance

20 days paid time off

4 weeks paid parental leave

9 paid holidays

401K company match up to 5%

Adoption Assistance Program

Flexible Spending Account

Educational Assistance Plan and Pro/M–

Referral Bonus Program - up to $750!

Job summary

Navitus is seeking an experienced Director, Network Pricing & Market Planning to own pharmacy network financial performance across all lines of business. You will translate pricing strategies into measurable outcomes, oversee reconciliation, MAC pricing, and governance, and collaborate with contract, underwriting, finance, and analytics teams.

You will lead a team focused on effective rate performance, MAC adjustments, and pricing governance to ensure contracted reimbursement aligns with terms,

Qualifications

• Bachelor’s degree or equivalent work experience required.
• 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.

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, measure, and report on network performance vs. targets and drive corrective actions.
• Provide governance and controls for MAC pricing, effective rate, NADAC, PAC, and other constructs.
• Oversee MAC pricing strategy execution and ongoing performance monitoring.

Skills

Leadership

Pricing strategy

Market analysis

RFP pricing

Matrix management

Compliance

Team development

Education

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

Job description

Navitus is seeking an experienced Director, Network Pricing & Market Planning to own pharmacy network financial performance across all lines of business. You will translate pricing strategies into measurable outcomes, oversee reconciliation, MAC pricing, and governance, and collaborate with contract, underwriting, finance, and analytics teams.

You will lead a team focused on effective rate performance, MAC adjustments, and pricing governance to ensure contracted reimbursement aligns with terms,