Remote Pharmacy Contracting & Network Specialist

Navitus; Denver (CO); Remote; USD 65,000 - 95,000; Full time

Benefits offered by this job

Health, Dental, and Vision insurance

20 days paid time off

4 weeks paid parental leave

9 paid holidays

401K company match up to 5%

Adoption Assistance Program

Flexible Spending Account

Educational Assistance Plan and Pro/MB

Referral Bonus Program – up to $750!

Job summary

Navitus Health Solutions is seeking a Pharmacy Relations Specialist to join our team in a dynamic pharmacy network role. This position focuses on contracting with independent pharmacies and select chains, ensuring compliance with network agreements, and supporting audits and communications.

The role requires experience in pharmacy operations, claims analysis, and strong collaboration with network pharmacies and internal teams.

Qualifications

• College or 2-year Technical Degree or equivalent experience preferred.
• Certified Pharmacy Technician preferred.
• 3 years business-setting experience.
• Retail pharmacy experience or managed care exposure desired.
• Prior experience analyzing medical and/or pharmacy claims desirable.
• Proficient in Microsoft Office and industry related software.
• Participate in, adhere to, and support compliance program objectives.
• Ability to interact cooperatively and respectfully with others.

Responsibilities

• Manage pharmacy contracting with independent pharmacies and select chains/PSAOs; assist management with network negotiations, including redline reviews.
• Review pharmacy contract setup to ensure compliance with network agreements.
• Support pharmacy audits and network compliance initiatives.
• Research and resolve claim issues and concerns.
• Respond to and track requests, inquiries, and communications with network pharmacies.
• Develop, review, and distribute pharmacy communications to meet internal and client requests.
• Monitor, track, and report pharmacy compliance with regulations and internal policies.
• Review independent pharmacy redlines and respond with minimal senior leadership input.
• Maintain all aspects of pharmacy network functions, including network plan design, quality assurance, and claims processing.
• Other duties as assigned.

Skills

Contracting processes

MS Office

Communication

Healthcare/pharmacy domain knowledge

Claims analysis

Interpersonal collaboration

Education

College or technical degree

Tools

MS Office

Job description

Navitus Health Solutions is seeking a Pharmacy Relations Specialist to join our team in a dynamic pharmacy network role. This position focuses on contracting with independent pharmacies and select chains, ensuring compliance with network agreements, and supporting audits and communications.

The role requires experience in pharmacy operations, claims analysis, and strong collaboration with network pharmacies and internal teams.