Remote Pharmacy Network Relations Specialist II

Navitus; Boise (ID); Remote; USD 60,000 - 80,000; Full time

Benefits offered by this job

Health, Dental, Vision

PTO 20 days

Parental leave 4 weeks

Holidays 9

401K match 5%

Adoption assistance

FSAs

Education assistance

Referral bonus $750

Job summary

Navitus Health Solutions seeks a Pharmacy Relations Specialist to manage contracting with pharmacies, ensure contract compliance, and support audits and network operations. The role requires direct interaction with pharmacies and experience in healthcare settings.

Ideal candidates have a technical degree or pharmacy technician credential, plus 3 years of business experience and proficiency with MS Office. Navitus offers strong benefits and a remote-friendly environment.

Qualifications

• College or 2-year technical degree or equivalent experience preferred.
• Certified Pharmacy Technician preferred.
• 3 years business-setting experience required.
• Retail or managed care pharmacy experience desired.
• Experience analyzing medical/pharmacy claims preferred.
• Proficiency in Microsoft Office and related software.
• Demonstrated compliance program participation.

Responsibilities

• Manage pharmacy contracting with independent pharmacies and select chains/PSAOs, including redline reviews.
• Review pharmacy contract setup for 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 needs.
• Monitor and report pharmacy compliance with regulations and internal policies.
• Handle maintenance of network functions, plan design builds, QA, and claims processing.

Skills

Interpersonal skills

Communication

Education

College or 2-year Technical Degree or equivalent experience

Certified Pharmacy Technician

Tools

Microsoft Office

Job description

Navitus Health Solutions seeks a Pharmacy Relations Specialist to manage contracting with pharmacies, ensure contract compliance, and support audits and network operations. The role requires direct interaction with pharmacies and experience in healthcare settings.

Ideal candidates have a technical degree or pharmacy technician credential, plus 3 years of business experience and proficiency with MS Office. Navitus offers strong benefits and a remote-friendly environment.