Remote Pharmacy Contract Audit Specialist

Navitus; Denver (CO); Vor Ort; USD 65.000 - 90.000; Vollzeit

Benefits dieser Stelle

Health benefits

Paid time off

Parental leave

401(k) with match

Educational assistance

Zusammenfassung

Navitus is seeking an Analyst, Pharmacy Contract Audit to oversee contractual reimbursement accuracy across Retail, Specialty, and Mail Order networks. You will review claims data, audit networks for price changes, and ensure compliance with contracts using NCRx and PC2 systems.

Collaborate with multiple teams to remediate errors and validate terms. You will interpret contract language, investigate pricing discrepancies, and develop controls to improve end-to-end contract pricing processes.

Qualifikationen

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

Aufgaben

• Analyze and resolve pricing and contractual inquiries from providers, clients, and internal teams.
• Interpret contract language and compare pricing to adjudicated activity.
• Develop controls and oversight reporting for contract pricing across Retail, Specialty, and Mail Order.
• Perform rate testing, chain audits, and impact assessments.
• Prepare periodic reports on contractual compliance for Provider Services and leadership.

Kenntnisse

Analytics

Business acumen

Interpersonal skills

Ausbildung

Bachelor's degree or equivalent

Jobbeschreibung

Navitus is seeking an Analyst, Pharmacy Contract Audit to oversee contractual reimbursement accuracy across Retail, Specialty, and Mail Order networks. You will review claims data, audit networks for price changes, and ensure compliance with contracts using NCRx and PC2 systems.

Collaborate with multiple teams to remediate errors and validate terms. You will interpret contract language, investigate pricing discrepancies, and develop controls to improve end-to-end contract pricing processes.