Remote Pharmacy Contract Audit Analyst

Navitus Health Solutions / Lumicera Health Services; United States; Remote; USD 54,000 - 65,000; 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 matching up to 5%

Adoption Assistance Program

Flexible Spending Account

Educational Assistance & Professional

Referral Bonus Program - up to $750

Job summary

Navitus is seeking an Analyst, Pharmacy Contract Audit to join our Provider Services team remotely in the US. You will oversee reimbursement accuracy across Retail, Specialty, and Mail Order contracts, review claims data, and ensure compliance with contractual terms.

You will analyze pricing structures (AWP, WAC, NADAC, MAC, etc.), respond to inquiries, and develop controls and reports to track performance.

Qualifications

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

Responsibilities

• Analyze and resolve pricing inquiries from providers, clients, auditors, and internal teams regarding Retail, Specialty, and Mail Order pricing with focus on root causes.
• Interpret pharmacy contract language to compare pricing to adjudicated claims activity.
• Develop and maintain controls and oversight reporting for end-to-end contract pricing; implement new processes as needed.
• Responsible for pharmacy network rate testing, chain audits, analysis, and impact assessment.
• Submit service requests and engage teams to implement system updates/changes; communicate findings to leadership.

Skills

Analytical skills

Pricing analysis

Contract interpretation

Education

Bachelor’s degree or equivalent

Tools

NCRx

PC2

Job description

Navitus is seeking an Analyst, Pharmacy Contract Audit to join our Provider Services team remotely in the US. You will oversee reimbursement accuracy across Retail, Specialty, and Mail Order contracts, review claims data, and ensure compliance with contractual terms.

You will analyze pricing structures (AWP, WAC, NADAC, MAC, etc.), respond to inquiries, and develop controls and reports to track performance.