Remote Pharmacy Network Relations Specialist

Navitus; Baton Rouge (LA); À distance; USD 65 000 - 90 000; Plein temps

Avantages offerts par ce poste

Top-tier health, dental, and vision

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 Prof.

Referral Bonus Program – up to $750!

Résumé du poste

Navitus Health Solutions is seeking a Pharmacy Relations Specialist to join our team in a remote-capable role. The PRS II will leverage healthcare pharmacy experience to execute contracts, respond to inquiries, and maintain contracted networks.

Ideal candidates have at least 2 years in pharmacy or related interfacing roles, strong analytical and communication skills, and familiarity with compliance and claims processing. Navitus offers comprehensive benefits and growth opportunities.

Qualifications

• It is preferred that candidates have a college or 2-year technical degree or equivalent experience.
• Certified Pharmacy Technician credential is preferred.
• At least 3 years of business-setting experience in a related role.
• Retail pharmacy or managed care setting experience is desired.
• Experience analyzing medical and/or pharmacy claims is highly desirable.
• Proficiency in Microsoft Office and related industry software.
• Ability to participate in and support compliance program objectives.
• Ability to interact cooperatively and respectfully with colleagues.

Responsabilités

• Manage pharmacy contracting with independents and select chains; assist negotiations with redline reviews.
• Review contract setup to ensure compliance with network agreements.
• Support pharmacy audits and network compliance initiatives.
• Research and resolve claim issues and inquiries from network pharmacies.
• Respond to and track requests 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 independent pharmacy redlines with minimal senior leadership input.
• Maintain pharmacy network functions including network plan design and claims processing.
• Perform other duties as assigned.

Connaissances

Analytical thinking

Communication skills

Compliance awareness

Interpersonal skills

Problem solving

Formation

College or technical degree in relevant field

Certified Pharmacy Technician

Outils

Microsoft Office

Pharmacy software

Description du poste

Navitus Health Solutions is seeking a Pharmacy Relations Specialist to join our team in a remote-capable role. The PRS II will leverage healthcare pharmacy experience to execute contracts, respond to inquiries, and maintain contracted networks.

Ideal candidates have at least 2 years in pharmacy or related interfacing roles, strong analytical and communication skills, and familiarity with compliance and claims processing. Navitus offers comprehensive benefits and growth opportunities.