Remote Pharmacy Relations Specialist II

Navitus; Annapolis (MD); Remote; USD 70,000 - 90,000; Full time

Benefits offered by this job

Health insurance

Dental insurance

Vision insurance

Paid time off 20 days

Parental leave 4 weeks

Holidays 9 days

401K company match up to 5%

Adoption assistance

Flexible Spending Account

Educational and membership assistance

Referral bonus program

Job summary

Navitus Health Solutions is seeking a Pharmacy Relations Specialist to join our team. This role focuses on contracting, responding to pharmacy inquiries, and maintaining contracted pharmacy networks.

You will engage with independent pharmacies and select chains, ensuring compliance with network agreements and regulatory requirements. The ideal candidate has at least 2 years in a pharmacy setting and experience in contracts, claims, and communications with network pharmacies.

Qualifications

• College or 2-year technical degree or equivalent experience preferred
• Certified Pharmacy Technician preferred
• 3 years business-setting experience
• Retail pharmacy or managed care setting experience desired
• Experience analyzing medical/pharmacy claims or credentials desired
• Proficient in Microsoft Office and industry related software
• Adherence to compliance program objectives
• Ability to interact cooperatively with employees

Responsibilities

• Manage pharmacy contracting with independent pharmacies and select chains/PSAOs, including redline reviews
• Review pharmacy contract setups 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 and distribute pharmacy communications for internal and client needs
• Monitor and report pharmacy compliance with regulations and policies
• Handle independent pharmacy redlines with minimal senior leadership input
• Maintain network functions, design builds, QA measures, and claims processing
• Other duties as assigned

Skills

Pharmacy contracting

Network negotiations

Compliance awareness

Problem solving

Effective communication

Education

College or 2-year technical degree

Certified Pharmacy Technician

Tools

Microsoft Office

Pharmacy software

Job description

Navitus Health Solutions is seeking a Pharmacy Relations Specialist to join our team. This role focuses on contracting, responding to pharmacy inquiries, and maintaining contracted pharmacy networks.

You will engage with independent pharmacies and select chains, ensuring compliance with network agreements and regulatory requirements. The ideal candidate has at least 2 years in a pharmacy setting and experience in contracts, claims, and communications with network pharmacies.