Remote Pharmacy Contracts & Relations Specialist II

Navitus; Topeka (KS); Remote; USD 60,000 - 85,000; 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-Mo

Referral Bonus Program – up to $750

Job summary

Navitus Health Solutions is seeking a Pharmacy Relations Specialist to join our team. The role involves managing pharmacy contracting with independent pharmacies and select chains, ensuring compliance with network agreements, and supporting audits and claims processing.

You will collaborate with internal teams to respond to inquiries, develop communications, and maintain network functions. The position requires at least 2 years in a pharmacy setting, strong MS Office skills, and the ability to

Qualifications

• College or 2-year Technical Degree or equivalent experience is preferred. Advanced technical education a plus.
• Certified Pharmacy Technician preferred.
• 3 years business-setting experience is required.
• Retail pharmacy experience or managed care setting desired.
• Prior experience analyzing medical and/or pharmacy claims is highly desired.
• Proficient in Microsoft Office and industry related software.
• Participate in, adhere to, and support compliance program objectives.
• The ability to interact cooperatively and respectfully with other employees.

Responsibilities

• Manage pharmacy contracting process with independent pharmacies and select chains/PSAOs; assist management with network negotiations and 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 for internal and client requests.
• Monitor and report pharmacy compliance with government regulations and internal policies.
• Review and respond to independent pharmacy redlines with minimal input from senior leadership.
• Maintain all aspects of pharmacy network functions, including network plan design, QA, and claims processing.
• Perform other duties as assigned.

Skills

Retail pharmacy experience

Pharmacy claims analysis

Interacting with pharmacies

Customer service

Education

College or 2-year Technical Degree or equivalent experience

Certified Pharmacy Technician

Tools

Microsoft Office

Job description

Navitus Health Solutions is seeking a Pharmacy Relations Specialist to join our team. The role involves managing pharmacy contracting with independent pharmacies and select chains, ensuring compliance with network agreements, and supporting audits and claims processing.

You will collaborate with internal teams to respond to inquiries, develop communications, and maintain network functions. The position requires at least 2 years in a pharmacy setting, strong MS Office skills, and the ability to