Remote Pharmacy Relations Specialist II

Navitus; Jefferson City (MO); Remote; USD 65,000 - 90,000; Full time

Benefits offered by this job

Health, Dental, Vision insurance

20 days paid time off

4 weeks parental leave

9 paid holidays

401K company match up to 5%

Adoption Assistance Program

Flexible Spending Account

Educational Assistance & Professional费

Referral Bonus up to $750

Job summary

Navitus Health Solutions is seeking a Pharmacy Relations Specialist to join our team. The role focuses on executing contracts with pharmacies, responding to inquiries, and maintaining contracted networks.

The PRS II should have 2+ years of related experience and be adept at network negotiations and compliance management. The position offers robust benefits and remote work options, with opportunities to advance within a collaborative healthcare environment.

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 and/or pharmacy claims desired.
• Proficient in Microsoft Office and industry related software.
• Participate in, adhere to, and support compliance program objectives.
• Ability to interact cooperatively and respectfully with other employees.

Responsibilities

• Manage pharmacy contracting with independent pharmacies and select chains; assist network negotiations, including 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 concerns.
• Respond to and track requests with network pharmacies.
• Develop, review, and distribute pharmacy communications for internal and client requests.
• Monitor and report pharmacy compliance with government regulations and internal policies.
• Review independent pharmacy redlines with minimal senior leadership input.
• Maintain maintenance of pharmacy network functions, including network plan design and claims processing.
• Other duties as assigned.

Skills

Pharmacy relations

Contract negotiations

Communication

Problem solving

Compliance awareness

Team collaboration

Client/vendor relations

Education

2-year technical degree or equivalent experience

Tools

Microsoft Office

Industry software

Job description

Navitus Health Solutions is seeking a Pharmacy Relations Specialist to join our team. The role focuses on executing contracts with pharmacies, responding to inquiries, and maintaining contracted networks.

The PRS II should have 2+ years of related experience and be adept at network negotiations and compliance management. The position offers robust benefits and remote work options, with opportunities to advance within a collaborative healthcare environment.