Remote Pharmacy Contract Audit Analyst

Navitus

Nashville (TN)

Remote

USD 65,000 - 90,000

Full time

5 days ago

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Benefits offered by this job

Health insurance

Dental insurance

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

Professional Membership assistance

Referral Bonus Program – up to $750

Job summary

Navitus Health Solutions seeks an Analyst, Pharmacy Contract Audit to oversee contractual reimbursement accuracy across Retail, Specialty, and Mail Order networks. You will audit pricing, analyze claims data, and support contract compliance using NCRx and PC2, collaborating with cross-functional teams to remediate issues.

The role supports the Provider Relations team, communicates findings, creates reports, and contributes to process improvements.

Qualifications

Bachelor’s degree or equivalent experience; emphasis in business, finance, economics, or operations preferred.
Minimum two years analytics experience required.
Participate in, adhere to, and support compliance program objectives.
Ability to interact cooperatively and respectfully with others.

Responsibilities

Analyze and resolve inquiries from pharmacy providers, clients, auditors, and internal teams regarding pricing with root-cause focus.
Interpret contract language to compare pricing to adjudicated claims activity.
Develop controls and oversight reporting for Retail, Specialty, and Mail Order contract pricing.
Test pharmacy network rates, perform chain audits, and assess impact.
Submit service or recovery requests and coordinate system changes.