Specialist II, Pharmacy Relations
United States
Company
NavitusAbout Us
Navitus - 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.Pay Range
USD $47,309.00 - USD $56,321.00 /Yr.Work Schedule Description (e.g. M-F 8am to 5pm)
M-F 8am to 5pmRemote Work Notification
ATTENTION: We are unable to offer remote work to residents of Alaska, Hawaii, Maine, Mississippi, New Hampshire, New Mexico, Rhode Island, South Carolina, South Dakota, West Virginia, and Wyoming.Overview
Navitus Health Solutions is seeking a Pharmacy Relations Specialist II to join our Provider Services team!
The Pharmacy Relations Specialist (PRS II) is a highly motivated professional with at least 2 years of successful experience working in a pharmacy or interfacing directly with pharmacies or accounts, preferably in healthcare. Responsibilities include executing contracts with pharmacies, responding to pharmacy inquiries, and completing the tactical and operational tasks required to maintain contracted pharmacy networks.
Is this you? Find out more below!
Responsibilities
How do I make an impact on my team?
- 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
Qualifications
What our team expects from you?
- College or 2-year Technical Degree or equivalent experience is preferred. Advanced technical education a plus
- 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
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.
Location : Address
RemoteLocation : Country
US ApplyJob Profile
Hawaii Maine Mississippi New Hampshire New Mexico No remote work for residents of certain states Rhode Island South Carolina South Dakota West Virginia Wyoming
Benefits/Perks20 days paid time off 20 Days PTO 401k company match 401(k) match 4 weeks 4 weeks paid parental leave 4 weeks parental leave 9 Paid Holidays Adoption Assistance Creativity Dental Insurance Diversity Flexible Spending Account Health insurance Paid holidays Paid parental leave Paid Time Off Remote work Vision Insurance
Tasks- Maintain pharmacy networks
- Manage pharmacy contracting
- Respond to pharmacy inquiries
Claims processing Communication Communications Compliance Contract management Creativity Health Healthcare Insurance Leadership Microsoft Office Pharmacy audits Pharmacy Claims Pharmacy relations Pharmacy Technician Problem-solving Quality Assurance Research
Experience2 years
Education2-year technical degree Advanced technical education Business Certified pharmacy technician College degree Communications Quality Assurance
Certifications TimezonesAmerica/Anchorage America/Chicago America/Denver America/Los_Angeles America/New_York Pacific/Honolulu UTC-10 UTC-5 UTC-6 UTC-7 UTC-8 UTC-9