Analyst, Pharmacy Audit-Remote - Madison, WI, US | Remote, US | Austin, TX, US | Appleton, WI, US

Putting People First in Pharmacy- Navitus was founded as an alternative to traditional pharmacy benefit manager (PBM) models.  We are committed to removing cost from the drug supply chain to make medications more affordable for the people who need them.   At Navitus, our team members work in an environment that celebrates diversity, fosters creativity and encourages growth.  We welcome new ideas and share a passion for excellent service to our customers and each other.  

Due to growth, we are adding this Analyst, Pharmacy Audit to our Provider Services department.

We are unable to offer remote work to residents of Alaska, Hawaii, Maine, Mississippi, New Hampshire, New Mexico, North Dakota, Rhode Island, South Carolina, South Dakota, West Virginia, and Wyoming.

The Analyst, Pharmacy Audit is responsible for the oversight of Navitus’ contractual pharmacy network reimbursement accuracy.  The individual in this position is expected to make independent assessments to confirm Navitus is conforming to contractual reimbursement obligations contained in Retail, Specialty, and Mail Order pharmacy agreements.  The Analyst will continually review and monitor claims data, create, and update procedures, audit networks for price change accuracy, monitor compliance with Navitus pharmacy provider contracts, communicate findings, and work with applicable teams to remediate errors. 

Is this you? Find out more below! 

How do I make an impact on my team?  

• Analytical and operational understanding of Navitus’ reimbursement programs including AWP, WAC, MAC, NADAC, FUL, AAC, Average Dispensing Fee, and other pricing structures.
• Responsible for fielding, analyzing, and resolving inquiries from pharmacy providers, clients, auditors, and internal teams regarding Retail, Specialty, and Mail Order pricing errors with focus on the root cause.
• Interpret pharmacy contract language to compare Retail, Specialty, and Mail Order contract pricing …