Remote Pharmacy Relations Specialist II - Network Contracts

Navitus; Nashville (TN); On-site; USD 65,000 - 85,000; Full time

Benefits offered by this job

Health insurance

Paid time off

Parental leave

Holidays

401K match

Adoption assistance

FSAs

Education assistance

Membership assistance

Referral bonus

Job summary

Navitus Health Solutions is seeking a Pharmacy Relations Specialist to join our team. The PRS II will manage contracting with pharmacies, respond to inquiries, and handle operational tasks to maintain contracted networks. A minimum of 2 years in a pharmacy setting is preferred.

Responsibilities include negotiating network terms, ensuring contract compliance, supporting audits, and maintaining network operations. The role emphasizes collaboration, problem solving, and adherence to policies.

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
• Prior experience analyzing medical/pharmacy claims or credentials desired
• Proficient in Microsoft Office and industry software
• Support compliance program objectives
• Ability to interact cooperatively with others

Responsibilities

• Manage pharmacy contracting process with independent pharmacies and select chains/PSAOs and assist management with network negotiations; includes redline reviews
• Review pharmacy contracts 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 and client requests
• Monitor and report pharmacy compliance with regulations and internal policies
• Review independent pharmacy redlines with minimal senior leadership input
• Maintain network functions such as network plan design, QA measures, and claims processing
• Other duties as assigned

Skills

Pharmacy contracting

Network negotiations

Compliance

Claims analysis

Customer communication

Microsoft Office

Problem solving

Education

2-year college degree / equivalent experience

Certified Pharmacy Technician preferred

Job description

Navitus Health Solutions is seeking a Pharmacy Relations Specialist to join our team. The PRS II will manage contracting with pharmacies, respond to inquiries, and handle operational tasks to maintain contracted networks. A minimum of 2 years in a pharmacy setting is preferred.

Responsibilities include negotiating network terms, ensuring contract compliance, supporting audits, and maintaining network operations. The role emphasizes collaboration, problem solving, and adherence to policies.