Remote Pharmacy Network Relations Specialist II

Navitus; Helena (MT); Remote; USD 65.000 - 85.000; Vollzeit

Benefits dieser Stelle

Health, Dental, and Vision insurance

Paid time off (20 days)

Parental leave (4 weeks)

9 paid holidays

401K match up to 5%

Adoption Assistance

Flexible Spending Account

Educational Assistance

Referral Bonus up to $750

Zusammenfassung

Navitus Health Solutions is hiring a Pharmacy Relations Specialist to join our team. The role focuses on contracting with pharmacies, maintaining contracted networks, and addressing pharmacy inquiries to support client networks.

The PRS II will manage redlines, ensure contract compliance, and facilitate communications across pharmacies and internal teams to uphold network integrity and service quality.

Qualifikationen

• College or 2-year Technical Degree or equivalent experience preferred.
• Certified Pharmacy Technician preferred.
• 3 years business-setting experience required.
• Retail pharmacy or managed care experience desired.
• Experience analyzing medical/pharmacy claims or credentials highly desired.
• Proficient in Microsoft Office and industry software.

Aufgaben

• Manage pharmacy contracting with independent pharmacies and select chains/PSAOs; assist with network negotiations.
• Review pharmacy contract setup for compliance with network agreements.
• Support pharmacy audits and network compliance initiatives.
• Research and resolve claim issues and concerns.
• Respond to and track requests and communications with network pharmacies.
• Develop and distribute pharmacy communications for internal and client requests.

Kenntnisse

Office proficiency

Pharmacy claims analysis

Interpersonal collaboration

Network negotiations

Compliance understanding

Ausbildung

College or technical degree

Certified Pharmacy Technician

Tools

Industry software

Jobbeschreibung

Navitus Health Solutions is hiring a Pharmacy Relations Specialist to join our team. The role focuses on contracting with pharmacies, maintaining contracted networks, and addressing pharmacy inquiries to support client networks.

The PRS II will manage redlines, ensure contract compliance, and facilitate communications across pharmacies and internal teams to uphold network integrity and service quality.