Remote Pharmacy Relations Specialist II: Network Contracts

Navitus; Washington (District of Columbia); Remote; USD 65,000 - 90,000; Full time

Benefits offered by this job

Health insurance – medical, dental, &

Paid time off – 20 days

Paid parental leave – 4 weeks

Paid holidays – 9

401K match – up to 5%

Adoption Assistance Program

Flexible Spending Account

Educational Assistance Plan & Prof. M‑

Referral Bonus Program – up to $750

Job summary

Navitus Health Solutions is seeking a Pharmacy Relations Specialist to join our team, bringing at least 2 years of pharmacy-related experience. You will manage contracting with independent pharmacies and networks, respond to inquiries, and handle operational tasks to maintain contracted networks.

Ideal candidates will have a college or technical degree, pharmacy technician certification preferred, and strong proficiency in Microsoft Office.

Qualifications

• College or 2-year Technical Degree or equivalent experience preferred.
• Certified Pharmacy Technician preferred.
• 3 years business-setting experience.
• Retail pharmacy experience or experience in a managed care pharmacy setting desired.
• Prior experience analyzing medical and/or pharmacy claims or credentials are highly desired.
• Proficient in Microsoft Office and industry related software.
• Participate in, adhere to, and support compliance program objectives.
• The ability to consistently interact cooperatively and respectfully with other employees.

Responsibilities

• Manage pharmacy contracting process with independent pharmacies and select chains/PSAOs and assist management with network negotiations; inclusive of redline reviews
• Review pharmacy contract setup to ensure compliance with pharmacy network agreements
• Support pharmacy audits and network compliance initiatives
• Research and problem solve to resolve claim issues and concerns
• Respond to and track requests, inquiries, and communications with network pharmacies
• Develop, review, and distribute pharmacy communications to meet internal and client requests
• Monitor, track, and report pharmacy compliance with guiding government regulations and internal policies and procedures
• Reviews and responds to independent pharmacy redlines; with little to no input from senior leadership
• Responsible for all aspects of maintenance related to pharmacy network functions, such as, network plan design builds, quality assurance measures and claims processing in general
• Other duties as assigned

Job description

Navitus Health Solutions is seeking a Pharmacy Relations Specialist to join our team, bringing at least 2 years of pharmacy-related experience. You will manage contracting with independent pharmacies and networks, respond to inquiries, and handle operational tasks to maintain contracted networks.

Ideal candidates will have a college or technical degree, pharmacy technician certification preferred, and strong proficiency in Microsoft Office.