Remote Pharmacy Contract Audit Analyst

Navitus; Salt Lake City (UT); Remote; USD 60,000 - 85,000; Full time

Benefits offered by this job

Health insurance

Dental insurance

Vision insurance

Paid time off

Parental leave

401K company match

Job summary

Navitus Health Solutions seeks an Analyst, Pharmacy Contract Audit to oversee contractual pharmacy network reimbursement accuracy across Retail, Specialty, and Mail Order. You will review claims data, interpret contract language, and develop controls and reports to validate pricing compliance.

Collaboration with cross-functional teams will be essential to remediate errors and improve processes. The role emphasizes analytical work, data interpretation, and producing audits and reports to ensure

Qualifications

• Bachelor's degree or equivalent experience required.
• Minimum two years analytics experience.
• Ability to interact cooperatively and respectfully with others.

Responsibilities

• Analyze and validate Navitus’ contractual pharmacy network reimbursement accuracy.
• Review claims data and audit networks for price-change accuracy.
• Interpret contract language to compare contract pricing to adjudicated claims activity.
• Develop and maintain controls and reporting for contract pricing across Retail, Specialty, and Mail Order.
• Perform network rate testing and audits; assess impact of changes.
• Escalate and resolve pharmacy pricing setup issues with applicable teams.
• Create reports to validate system accuracy against contractual terms.

Skills

Analytics experience

Interpersonal skills

Compliance awareness

Education

Bachelor's degree

Tools

NCRx

PC2

Job description

Navitus Health Solutions seeks an Analyst, Pharmacy Contract Audit to oversee contractual pharmacy network reimbursement accuracy across Retail, Specialty, and Mail Order. You will review claims data, interpret contract language, and develop controls and reports to validate pricing compliance.

Collaboration with cross-functional teams will be essential to remediate errors and improve processes. The role emphasizes analytical work, data interpretation, and producing audits and reports to ensure