Remote Pharmacy Contract Audit Analyst - Data & Compliance

Navitus; Boise (ID); Remote; USD 65,000 - 95,000; Full time

Benefits offered by this job

Health, dental, and vision insurance

Paid time off

Parental leave

401K match

Adoption assistance

Flexible Spending Account

Educational assistance

Professional membership assistance

Referral bonus

Job summary

Navitus Health Solutions is seeking an Analyst, Pharmacy Contract Audit to oversee contractual pharmacy network reimbursement accuracy across Retail, Specialty, and Mail Order agreements. You will review claims data, interpret contract terms, and develop controls to ensure pricing integrity in NCRx and PC2 systems.

You will collaborate with cross-functional teams, field inquiries from providers and clients, and create reports validating compliance with contractual terms.

Qualifications

• Bachelor’s degree or equivalent experience required; emphasis in business, finance, economics, or operations preferred.
• Minimum two years analytics experience required.
• Ability to interact cooperatively and respectfully with others.
• Participate in, adhere to, and support compliance program objectives.

Responsibilities

• Oversee contractual pharmacy network reimbursement accuracy across Retail, Specialty, and Mail Order agreements.
• Review and monitor claims data, communicate findings, and remediate errors with applicable teams.
• Interpret contract language to compare pricing to adjudicated claims activity.
• Develop controls and reporting for end-to-end contract pricing processes.
• Conduct network rate testing, audits, and impact assessments.

Skills

Pricing analytics

Claims data analysis

Root cause analysis

Pricing structures

Stakeholder communication

Education

Bachelor’s degree

Tools

NCRx

PC2

Job description

Navitus Health Solutions is seeking an Analyst, Pharmacy Contract Audit to oversee contractual pharmacy network reimbursement accuracy across Retail, Specialty, and Mail Order agreements. You will review claims data, interpret contract terms, and develop controls to ensure pricing integrity in NCRx and PC2 systems.

You will collaborate with cross-functional teams, field inquiries from providers and clients, and create reports validating compliance with contractual terms.