Remote Network Contracting Manager - Pharmacy PBM

Visa Hunt; United States; On-site; USD 101,335 - 126,669; Full time

Benefits offered by this job

Health insurance

Dental insurance

Vision insurance

Paid time off

Parental leave

Holidays

401K match

Adoption assistance

Flexible Spending Account

Educational assistance

Referral bonus

Job summary

Navitus Health Solutions is seeking a Network Contracting Manager to join our team from a remote US-based location. The role leads management of retail, specialty, and mail-order pharmacy contracts, with a focus on compliance, value-based metrics, and payer negotiations across Commercial, Medicare Part D, and Managed Medicaid.

The ideal candidate has a Bachelor’s degree or higher, 1–3 years PBM/Managed Care experience, and familiarity with CMS and Medicaid regulations.

Qualifications

• Bachelor’s degree or higher in a related field is preferred.
• Minimum 1 - 3 years PBM or Managed Care experience is highly desired.
• Understanding of managed care, retail and specialty pharmacy network concepts is highly desired.
• Experience with CMS, Medicare, and state Medicaid regulations is preferred.

Responsibilities

• Negotiate pharmacy network reimbursement and contracts for Commercial, Medicare Part D, Managed Medicaid, and other networks.
• Negotiate and execute pay-for-performance program contracts with pharmacies.
• Ensure network compliance with regulatory and contractual obligations.
• Assist in setting market competitive pricing and contract terms.

Skills

PBM knowledge

Education

Bachelor’s degree or higher in a related field

Job description

Navitus Health Solutions is seeking a Network Contracting Manager to join our team from a remote US-based location. The role leads management of retail, specialty, and mail-order pharmacy contracts, with a focus on compliance, value-based metrics, and payer negotiations across Commercial, Medicare Part D, and Managed Medicaid.

The ideal candidate has a Bachelor’s degree or higher, 1–3 years PBM/Managed Care experience, and familiarity with CMS and Medicaid regulations.