Remote Pharmacy Contract Audit Analyst

Navitus; Montpelier (VT); Remote; USD 60,000 - 90,000; Full time

Benefits offered by this job

Health insurance

Dental insurance

Vision insurance

PTO 20 days

Parental leave 4 weeks

9 holidays

401K match up to 5%

Adoption assistance

FSAs

Educational assistance

Referral bonus

Job summary

Navitus is seeking an Analyst, Pharmacy Contract Audit to oversee our contractual pharmacy network reimbursement accuracy. You will review claims data, audit pricing, and create procedures to ensure alignment with Retail, Specialty, and Mail Order contracts.

You’ll use NCRx and PC2 to validate terms and report findings to cross-functional teams. The role requires analytical rigor, at least two years of analytics experience, and the ability to collaborate with providers, clients, and internal

Qualifications

• Bachelor’s degree or equivalent experience required.
• Minimum two years analytics experience.
• Support compliance program objectives.
• Ability to interact cooperatively and respectfully with colleagues.

Responsibilities

• Analyze pricing and resolve inquiries from providers, clients, and auditors.
• Interpret contract language to compare pricing to adjudicated activity.
• Develop controls and oversight reporting for contract pricing.
• Conduct network rate testing and performance analysis.
• Communicate findings to Provider Services and leadership.
• Submit service requests and coordinate system updates as needed.
• Follow and improve operational processes.
• Produce periodic reports on contractual compliance.

Skills

Analytical skills

Data analysis

Collaboration

Education

Bachelor’s degree or equivalent

Tools

NCRx

PC2

Job description

Navitus is seeking an Analyst, Pharmacy Contract Audit to oversee our contractual pharmacy network reimbursement accuracy. You will review claims data, audit pricing, and create procedures to ensure alignment with Retail, Specialty, and Mail Order contracts.

You’ll use NCRx and PC2 to validate terms and report findings to cross-functional teams. The role requires analytical rigor, at least two years of analytics experience, and the ability to collaborate with providers, clients, and internal