Remote Director, PBM Network Pricing & MAC Strategy

Navitus; Annapolis (MD); Remote; USD 180,000 - 260,000; Full time

Benefits offered by this job

Health, dental, and vision insurance

20 days paid time off

4 weeks paid parental leave

9 paid holidays

Job summary

Navitus Health Solutions is seeking an experienced Director to own pharmacy network financial performance across all lines of business, ensuring contracted reimbursement guarantees and MAC pricing outcomes are realized. The role leads Network Reconciliation and MAC Pricing teams, delivering governance and post-contract performance realization.

The position requires deep PBM expertise, strong leadership, and collaboration with contracting, underwriting, finance, and analytics to translate terms

Qualifications

• Bachelor’s degree in Business, Finance, Economics, or Healthcare Administration, or related field, or equivalent work experience, required.
• 7+ years of progressive PBM, healthcare plan, pharmacy network, or related experience required.
• 3+ years of leadership experience with a proven ability to develop high-performing teams and deliver tangible results in a professional services environment required.
• Demonstrated experience in pricing strategy, market analysis, or network planning required.
• Experience supporting RFP pricing and competitive market analysis required.
• Prior experience leading or matrix‑management experience preferred.
• Participate in, adhere to, and support compliance program objectives.
• The ability to consistently interact cooperatively and respectfully with other employees.

Responsibilities

• Lead the Network Reconciliation function with full accountability for validating pharmacy network performance against contracted effective rates (BER/GER) 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 performance variances and drive corrective actions in partnership with Network Contracting and Pricing teams.
• Insure audit readiness, financial transparency, and governance across all reconciliation activities.
• Provide oversight of pharmacy network performance across all pricing constructs (e.g., effective rate, MAC, NADAC, PAC, flat AWP).

Skills

Pricing strategy

PBM expertise

Reimbursement analytics

Network pricing governance

Leadership

Cross-functional collaboration

Contracting & negotiation

Education

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

Job description

Navitus Health Solutions is seeking an experienced Director to own pharmacy network financial performance across all lines of business, ensuring contracted reimbursement guarantees and MAC pricing outcomes are realized. The role leads Network Reconciliation and MAC Pricing teams, delivering governance and post-contract performance realization.

The position requires deep PBM expertise, strong leadership, and collaboration with contracting, underwriting, finance, and analytics to translate terms