Remote Pharmacy Contract Audit Analyst

Navitus; Carson City (NV); Remote; USD 70,000 - 90,000; Full time

Benefits offered by this job

Health insurance

Dental insurance

Vision insurance

Paid time off

Parental leave

401(k) match

Adoption Assistance

Flexible Spending Account

Educational assistance

Referral bonus

Job summary

Navitus is seeking an Analyst, Pharmacy Contract Audit to oversee contractual reimbursement accuracy across Retail, Specialty, and Mail Order networks. The role requires evaluating claims data, auditing pricing, and ensuring compliance with contracts using NCRx and PC2 systems.

The position emphasizes analytical rigor, cross-functional collaboration, and proactive process improvement to support Navitus’ network and client objectives.

Qualifications

• 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.

Responsibilities

• Analyze and resolve pricing inquiries from pharmacy providers, clients, auditors, and internal teams.
• Interpret contract language to compare pricing to adjudicated claims activity.
• Develop and maintain controls and oversight reporting for contract pricing across Retail, Specialty, and Mail Order.
• Conduct network rate testing, chain audits, and impact assessment.
• Submit service or recovery requests and coordinate system updates when needed.
• Periodically report contractual compliance activities to Provider Services and leadership.

Skills

Analytics experience

Interpersonal skills

Education

Bachelor’s degree or equivalent experience

Tools

NCRx

PC2

Job description

Navitus is seeking an Analyst, Pharmacy Contract Audit to oversee contractual reimbursement accuracy across Retail, Specialty, and Mail Order networks. The role requires evaluating claims data, auditing pricing, and ensuring compliance with contracts using NCRx and PC2 systems.

The position emphasizes analytical rigor, cross-functional collaboration, and proactive process improvement to support Navitus’ network and client objectives.