Remote Pharmacy Contract Audit Analyst

Navitus; Frankfort (KY); Remote; USD 60,000 - 80,000; Full time

Benefits offered by this job

Health, Dental, and Vision insurance

Paid time off

Parental leave

9 paid holidays

401K company match

Adoption Assistance Program

Educational Assistance Plan

Referral Bonus Program

Job summary

Navitus Health Solutions is hiring an Analyst, Pharmacy Contract Audit to oversee contractual pharmacy network reimbursement accuracy across Retail, Specialty, and Mail Order programs. The role involves reviewing claims data, auditing price changes, ensuring contract compliance, and generating reports to validate system accuracy.

The analyst will interpret contract language, cooperate with cross-functional teams, and help remediate errors within Navitus’ NCRx system and PC2 databases.

Qualifications

• Bachelor’s degree or equivalent experience required.
• 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 inquiries from providers, clients, auditors, and internal teams regarding pricing errors.
• Interpret contract language to compare pricing to adjudicated claims activity.
• Develop and maintain controls and reporting on the pricing process for Retail, Specialty, and Mail Order contracts.
• Test and assess pharmacy network rates, perform chain audits, and assess impact.
• Submit service or recovery requests and coordinate system updates as needed.
• Periodically report contractual compliance activities to leadership.

Skills

Analytical skills

Stakeholder communication

Compliance understanding

Education

Bachelor's degree

Tools

NCRx system

PC2

Job description

Navitus Health Solutions is hiring an Analyst, Pharmacy Contract Audit to oversee contractual pharmacy network reimbursement accuracy across Retail, Specialty, and Mail Order programs. The role involves reviewing claims data, auditing price changes, ensuring contract compliance, and generating reports to validate system accuracy.

The analyst will interpret contract language, cooperate with cross-functional teams, and help remediate errors within Navitus’ NCRx system and PC2 databases.