Remote Pharmacy Contract Audit Analyst

Navitus; Atlanta (GA); Remote; USD 60,000 - 80,000; Full time

Benefits offered by this job

Health insurance

PTO 20 days

Parental leave

Paid holidays

401K match

Adoption support

Flexible spending

Education & membership

Referral bonus

Job summary

Navitus Health Solutions is seeking an Analyst, Pharmacy Contract Audit to join our Provider Relations team. You will oversee contractual reimbursement accuracy across Retail, Specialty, and Mail Order programs, review claims data, and develop controls and reports to validate pricing against contracts.

You will interact with providers, clients, auditors, and internal teams to identify root causes of pricing discrepancies, test network rates, and implement remediation within the NCRx system and

Qualifications

• Bachelor’s degree or equivalent experience required in business, finance, economics, or operations.
• Minimum two years analytics experience required.
• Support compliance program objectives and inter-team collaboration.

Responsibilities

• Analytical and operational understanding of Navitus’ reimbursement programs.
• Field and resolve inquiries from providers, clients, auditors, and internal teams.
• Interpret contract language to compare pricing to adjudicated claims.
• Develop and maintain end-to-end controls and reporting for contract pricing.
• Test pharmacy network rates, perform chain audits, assess impact.
• Make decisions on pricing setup issues.
• Submit service requests or trigger system updates.
• Follow and improve operational processes.
• Periodic reporting of compliance activities to Provider Services and leadership.
• Other duties as assigned.

Skills

Analytics experience

Compliance program objectives

Interpersonal communication

Education

Bachelor’s degree or equivalent experience

Job description

Navitus Health Solutions is seeking an Analyst, Pharmacy Contract Audit to join our Provider Relations team. You will oversee contractual reimbursement accuracy across Retail, Specialty, and Mail Order programs, review claims data, and develop controls and reports to validate pricing against contracts.

You will interact with providers, clients, auditors, and internal teams to identify root causes of pricing discrepancies, test network rates, and implement remediation within the NCRx system and