Remote Pharmacy Contract Audit Analyst

Navitus; Baton Rouge (LA); A distancia; USD 65.000 - 85.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Health, Dental, 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

Referral Bonus Program - up to $750

Descripción de la vacante

Navitus Health Solutions is seeking an Analyst, Pharmacy Contract Audit to join our Provider Relations team in a remote role. The analyst will oversee contractual pharmacy network reimbursement accuracy, review claims data, and create procedures to ensure Navitus complies with Retail, Specialty, and Mail Order agreements.

The position emphasizes independent assessment, reporting, and remediation of pricing errors across networks.

Formación

• Bachelor's degree or equivalent experience required. Emphasis in business, finance, economics, or operations preferred
• Minimum two years analytics experience required
• Participate in, adhere to, and support compliance program objectives
• The ability to consistently interact cooperatively and respectfully with other employees

Responsabilidades

• Oversee Navitus' contractual pharmacy network reimbursement accuracy across Retail, Specialty, and Mail Order agreements.
• Review and analyze claims data, and develop and update procedures.
• Audit networks for price change accuracy and monitor contract compliance.
• Communicate findings and remediate errors with applicable teams.
• Work with Navitus adjudication system (NCRx) and contracting databases (PC2).
• Create reports to validate systems accuracy to contractual terms.
• Perform network rate testing, chain audits, and impact assessments.
• Provide period reporting to Provider Services and leadership.

Conocimientos

Analytical mindset

Compliance focus

Team collaboration

Educación

Bachelor's degree or equivalent experience

Descripción del empleo

Navitus Health Solutions is seeking an Analyst, Pharmacy Contract Audit to join our Provider Relations team in a remote role. The analyst will oversee contractual pharmacy network reimbursement accuracy, review claims data, and create procedures to ensure Navitus complies with Retail, Specialty, and Mail Order agreements.

The position emphasizes independent assessment, reporting, and remediation of pricing errors across networks.