Director — Remote Network Pricing & Market Planning

Navitus Health Solutions, LLC; United States; Remote; USD 142,000 - 178,000; Full time

Benefits offered by this job

Health insurance

Dental insurance

Vision insurance

PTO 20 days

Parental leave

Holidays 9

401K match

Adoption assistance

FSA

Education assistance

Referral bonus

Job summary

Navitus Health Solutions, LLC is seeking an experienced leader for Network Pricing & Market Planning to own pharmacy network financial performance across all lines of business. The role focuses on achieving contracted reimbursement guarantees, MAC pricing outcomes, and effective rate performance.

Responsibilities include leading reconciliation, governance, and post-contract performance realization, with collaboration across Contracting, Underwriting, Finance, and Analytics teams.

Qualifications

• Bachelor’s degree in Business, Finance, Economics, or 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 a professional services environment.
• Pricing strategy, market analysis, or network planning experience.
• Experience supporting RFP pricing and competitive market analysis.
• Prior matrix-management experience preferred.
• Participate in, adhere to, and support compliance program objectives.
• Ability to interact cooperatively and respectfully with other employees.

Responsibilities

• Lead the Network Reconciliation function with accountability for validating network performance against contracted effective rates and pricing guarantees.
• Own reconciliation outcomes across all lines of business, ensuring accurate financial settlement and alignment to contract terms.
• Establish and enforce processes to monitor, measure, and report on network performance vs. contractual targets; identify variances and drive corrective actions.
• Insure audit readiness, financial transparency, and governance across all reconciliation activities.
• Provide oversight of pricing constructs (e.g., MAC, NADAC, PAC, AWP) ensuring outcomes align with reimbursement intent.

Skills

Pricing strategy

Market analysis

Network planning

Leadership

RFP pricing

Compliance

Education

Bachelor degree (Business/Finance/Healthcare)

Job description

Navitus Health Solutions, LLC is seeking an experienced leader for Network Pricing & Market Planning to own pharmacy network financial performance across all lines of business. The role focuses on achieving contracted reimbursement guarantees, MAC pricing outcomes, and effective rate performance.

Responsibilities include leading reconciliation, governance, and post-contract performance realization, with collaboration across Contracting, Underwriting, Finance, and Analytics teams.