Remote Pharmacy Relations Specialist II

Navitus; Richmond (VA); Remote; USD 60,000 - 90,000; Full time

Benefits offered by this job

Health insurance

Dental insurance

Vision insurance

Paid time off

Parental leave - 4 weeks

9 paid holidays

401K match

Job summary

Navitus Health Solutions is seeking a Pharmacy Relations Specialist to join our team in a dynamic, customer-focused role. The PRS II will manage contracting with pharmacies, support network negotiations, and ensure compliance with agreements and regulatory standards.

Ideal candidates have at least 2 years of experience in a pharmacy setting, proficiency with Microsoft Office, and a strong ability to interact professionally with a variety of stakeholders.

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 desired.
• Prior experience analyzing medical or pharmacy claims or credentials is highly desired.
• Proficient in Microsoft Office and industry related software.
• Participate in and support compliance program objectives.
• The ability to interact cooperatively and respectfully with colleagues.

Responsibilities

• Manage pharmacy contracting with independent pharmacies and select chains/PSAOs; assist with network negotiations and redline reviews.
• Review contract setups to ensure compliance with network agreements.
• Support pharmacy audits and network compliance initiatives.
• Research and resolve claim issues and concerns.
• Respond to and track inquiries with network pharmacies.
• Develop, review, and distribute pharmacy communications for internal and client requests.
• Monitor and report pharmacy compliance with regulations and internal policies.
• Review independent pharmacy redlines with limited senior leadership input.
• Maintain pharmacy network functions including network plan design and claims processing.
• Other duties as assigned.

Skills

Pharmacy contracting

Claims analysis

Microsoft Office

Interpersonal communication

Compliance awareness

Education

College or 2-year technical degree

Certified Pharmacy Technician

Tools

Industry software

Job description

Navitus Health Solutions is seeking a Pharmacy Relations Specialist to join our team in a dynamic, customer-focused role. The PRS II will manage contracting with pharmacies, support network negotiations, and ensure compliance with agreements and regulatory standards.

Ideal candidates have at least 2 years of experience in a pharmacy setting, proficiency with Microsoft Office, and a strong ability to interact professionally with a variety of stakeholders.