Remote Pharmacy Contract Audit Analyst

Navitus; Springfield (IL); Remote; USD 65,000 - 85,000; Full time

Benefits offered by this job

Health Insurance

Dental Insurance

Vision Insurance

Paid time off

Parental leave

401K company match

Adoption Assistance

Flexible Spending Account

Educational Assistance

Referral Bonus

Job summary

Navitus Health Solutions is expanding its Provider Relations team with an Analyst, Pharmacy Contract Audit to oversee contractual reimbursement accuracy for Retail, Specialty, and Mail Order networks. You will analyze claims data, interpret contract language, and support remediation of pricing discrepancies across multiple contracts.

The role emphasizes developing controls, periodic reporting, and collaboration with internal teams to ensure compliance with contractual terms and provider networks.

Qualifications

• Bachelor’s degree or equivalent experience required in business, finance, economics, or operations.
• Minimum two years analytics experience.
• Support compliance program objectives and collaborate with teams.

Responsibilities

• Oversee reimbursement accuracy within Retail, Specialty, and Mail Order contracts.
• Review claims data, interpret contract terms, and audit pricing against adjudicated activity.
• Develop controls and reporting for end-to-end contract pricing processes.
• Communicate findings and remediate errors with applicable teams.
• Produce reports validating system accuracy against contractual terms.

Skills

Analytics experience

Cross-functional collaboration

Attention to detail

Communication

Education

Bachelor’s degree or equivalent experience

Tools

NCRx

PC2

Job description

Navitus Health Solutions is expanding its Provider Relations team with an Analyst, Pharmacy Contract Audit to oversee contractual reimbursement accuracy for Retail, Specialty, and Mail Order networks. You will analyze claims data, interpret contract language, and support remediation of pricing discrepancies across multiple contracts.

The role emphasizes developing controls, periodic reporting, and collaboration with internal teams to ensure compliance with contractual terms and provider networks.