Remote Pharmacy Contract Audit Analyst

Navitus; Phoenix (AZ); Remote; USD 65,000 - 90,000; Full time

Benefits offered by this job

Health, Dental, Vision insurance

20 days paid time off

4 weeks paid parental leave

9 paid holidays

401K company match of up to 5% - No v

Adoption Assistance Program

Flexible Spending Account

Educational Assistance Plan and PT/MA

Referral Bonus Program - up to $750

Job summary

Navitus is seeking an Analyst, Pharmacy Contract Audit to oversee contractual reimbursement accuracy across Retail, Specialty, and Mail Order networks. You will analyze claims data, interpret contract terms, and create reports validating system accuracy and compliance.

The role collaborates with multiple teams to remediate errors and improve internal controls. The ideal candidate has a bachelor’s degree or equivalent, at least two years of analytics experience, and solid communication skills to

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

• Provide analytical insight to Navitus’ reimbursement programs (AWP, WAC, MAC, NADAC, FUL, AAC, fees) and pricing structures
• Field and resolve inquiries from providers, clients, auditors, and internal teams on pricing errors
• Interpret contract language to compare pricing to adjudicated claims activity
• Develop controls and oversight reporting for end-to-end pricing processes and implement new ones if needed
• Test and audit pharmacy network rates, perform chain audits and impact assessments
• Decide on resolution of pricing setup issues in the network
• Submit service or recovery requests and coordinate system updates as needed
• Understand and improve current operational processes and procedures
• Periodically report contractual compliance activities to Provider Services and leadership
• Perform other duties as assigned

Skills

Analytics experience

Interpersonal communication

Compliance awareness

Education

Bachelor’s degree or equivalent experience

Job description

Navitus is seeking an Analyst, Pharmacy Contract Audit to oversee contractual reimbursement accuracy across Retail, Specialty, and Mail Order networks. You will analyze claims data, interpret contract terms, and create reports validating system accuracy and compliance.

The role collaborates with multiple teams to remediate errors and improve internal controls. The ideal candidate has a bachelor’s degree or equivalent, at least two years of analytics experience, and solid communication skills to