Remote Pharmacy Contract Audit Specialist

Navitus; Raleigh (NC); Remote; USD 65,000 - 90,000; Full time

Benefits offered by this job

Health, dental, vision benefits

PTO 20 days

Parental leave 4 weeks

9 paid holidays

401K company match 5%

Adoption assistance

Flexible Spending Account

Education assistance and professionals

Referral bonus – up to $750

Job summary

Navitus Health Solutions is hiring an Analyst, Pharmacy Contract Audit to oversee contract reimbursement accuracy across Retail, Specialty, and Mail Order networks. You will review claims data, interpret contract terms, and help remediate pricing errors with cross-functional teams.

By analyzing pricing structures and applying controls, you will support compliance and network performance. This role offers comprehensive benefits and growth opportunities within a collaborative Provider Relations

Qualifications

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

Responsibilities

• Analyze Navitus reimbursement programs (AWP, WAC, MAC, NADAC, FUL, AAC) and pricing structures.
• Field and resolve inquiries from providers, clients, auditors, and internal teams about pricing errors.
• Interpret contract language to compare contract pricing with adjudicated claims activity.
• Develop controls and oversight reporting for end-to-end pricing processes.
• Test pharmacy network rates, perform chain audits, and assess impact.
• Submit service/recovery requests and coordinate system updates as needed.
• Communicate findings to Provider Services and leadership; support process improvements.

Skills

Analytics experience

Data analysis

Education

Bachelor’s degree or equivalent

Tools

NCRx

PC2

Job description

Navitus Health Solutions is hiring an Analyst, Pharmacy Contract Audit to oversee contract reimbursement accuracy across Retail, Specialty, and Mail Order networks. You will review claims data, interpret contract terms, and help remediate pricing errors with cross-functional teams.

By analyzing pricing structures and applying controls, you will support compliance and network performance. This role offers comprehensive benefits and growth opportunities within a collaborative Provider Relations