Remote Pharmacy Network Relations Specialist II

Navitus; Boston (MA); Remote; USD 65,000 - 90,000; Full time

Benefits offered by this job

Health Insurance

Paid Time Off - 20 days

Parental Leave - 4 weeks

Paid Holidays - 9 days

401K with company match

Job summary

Navitus Health Solutions is seeking a Pharmacy Relations Specialist to join our team in a remote capacity. The role focuses on contracting with pharmacies, responding to inquiries, and maintaining contracted networks across our client base.

The PRS II position requires a minimum of 2 years of experience in a pharmacy setting, familiarity with contract compliance, and strong proficiency in Microsoft Office. A focus on accuracy and collaborative problem-solving is essential.

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 setting desired
• Prior experience analyzing medical/pharmacy claims or credentials
• Proficient in Microsoft Office and industry 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 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 inquiries
• Respond to and track requests and inquiries from network pharmacies
• Develop, review, and distribute pharmacy communications for internal and client requests
• Monitor and report pharmacy compliance with regulations and internal policies
• Handle maintenance of network functions such as network design builds, QA measures, and claims processing
• Other duties as assigned

Job description

Navitus Health Solutions is seeking a Pharmacy Relations Specialist to join our team in a remote capacity. The role focuses on contracting with pharmacies, responding to inquiries, and maintaining contracted networks across our client base.

The PRS II position requires a minimum of 2 years of experience in a pharmacy setting, familiarity with contract compliance, and strong proficiency in Microsoft Office. A focus on accuracy and collaborative problem-solving is essential.