Remote Pharmacy Relations Specialist II

Navitus; Frankfort (KY); Remote; USD 60,000 - 90,000; Full time

Benefits offered by this job

Health insurance

PTO 20 days

Parental leave 4 weeks

9 paid holidays

401K company match up to 5%

Adoption Assistance

Flexible Spending Account

Educational Assistance Plan and Pro MS

Referral Bonus up to $750

Job summary

Navitus Health Solutions seeks a Pharmacy Relations Specialist to manage contracting with pharmacies and ensure network compliance. Ideal candidates have experience with claims, audits, and communications across the pharmacy network.

The role involves coordinating with independent pharmacies and PSAOs, reviewing contracts, and supporting regulatory alignment while maintaining strong client and internal relationships. This position may be remote within the US.

Qualifications

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

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.
• Respond to and track requests with network pharmacies.
• Develop and distribute pharmacy communications for internal/client needs.
• Monitor compliance with government regulations and internal policies.
• Handle network function maintenance like plan design builds and claims processing.

Skills

Pharmacy contracting

Network negotiations

Contract compliance

Claims processing

Pharmacy communications

Microsoft Office

Education

Associate degree or equivalent

Certified Pharmacy Technician

Tools

Microsoft Office

Job description

Navitus Health Solutions seeks a Pharmacy Relations Specialist to manage contracting with pharmacies and ensure network compliance. Ideal candidates have experience with claims, audits, and communications across the pharmacy network.

The role involves coordinating with independent pharmacies and PSAOs, reviewing contracts, and supporting regulatory alignment while maintaining strong client and internal relationships. This position may be remote within the US.