Remote Pharmacy Contract Audit Analyst

Navitus; Tallahassee (FL); Remote; USD 60,000 - 85,000; Full time

Benefits offered by this job

Top health benefits

20 days PTO

4 weeks parental leave

9 paid holidays

401K employer match

Adoption assistance

Flexible Spending Account

Educational assistance

Referral bonus up to $750

Job summary

Navitus Health Solutions is seeking an Analyst, Pharmacy Contract Audit to oversee contractual pharmacy network reimbursement accuracy, using NCRx and PC2 systems. The role requires reviewing claims data, interpreting contract terms, and reporting on pricing compliance across Retail, Specialty, and Mail Order channels.

The ideal candidate has a minimum of two years of analytics experience and a bachelor's degree.

Qualifications

• Bachelor's degree or equivalent; emphasis in business, finance, economics, or operations preferred.
• Minimum two years analytics experience.
• Support compliance program objectives and work with cross-functional teams.

Responsibilities

• Analyze Navitus' reimbursement programs (AWP, WAC, MAC, NADAC, FUL, AAC, etc.).
• Investigate pricing errors for Retail, Specialty, and Mail Order contracts with root-cause focus.
• Interpret contract language to compare pricing to adjudicated claims.
• Develop controls and reporting for end-to-end contract pricing processes.
• Support system updates and remediation with applicable teams.
• Prepare periodic reports on contractual compliance for leadership.

Skills

Analytics experience

Compliance awareness

Education

Bachelor's degree or equivalent

Tools

NCRx

PC2

Job description

Navitus Health Solutions is seeking an Analyst, Pharmacy Contract Audit to oversee contractual pharmacy network reimbursement accuracy, using NCRx and PC2 systems. The role requires reviewing claims data, interpreting contract terms, and reporting on pricing compliance across Retail, Specialty, and Mail Order channels.

The ideal candidate has a minimum of two years of analytics experience and a bachelor's degree.