Reimbursement Analyst, Pharmacy Network

Company

Navitus

About 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._____________________________________________________________________________________________________________________________________________________________________________________________________________. Current associates must use SSO login option at https://employees-navitus.icims.com/ to be considered for internal opportunities. ____________________________________________________We are committed to providing equal employment opportunity to all applicants and employees and comply with all applicable nondiscrimination regulations, including those related to protected veterans and individuals with disabilities. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, or handicap.

Pay Range

USD $52,656.00 - USD $62,686.00 /Yr.

STAR Bonus % (At Risk Maximum)

5.00 - Salaried Non-Management except pharmacists

Work Schedule Description (e.g. M-F 8am to 5pm)

M-F 8am to 5pm

Remote Work Notification

ATTENTION: Navitus is 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.

Overview

Due to growth, we are adding a Reimbursement Analyst, Pharmacy Network to our team.

 

The Reimbursement Analyst, Pharmacy Network is responsible for the operation of the Navitus Maximum Allowable Cost (MAC) pricing program and other generic and brand reimbursement systems with pharmacy providers.  The objective is to achieve market leading discounts, fair reimbursement to providers, and to ensure maximum competitive pricing is attained.

 

The Reimbursement Analyst, Pharmacy Network supports and evaluates agreements with providers and the MAC program through financial price modeling, analysis, and reporting. This position will communicate and work cross functionally with other teams on generic trends and generic drug discount change effects. Provider and network performance will be analyzed in support of network development, contracting negotiations, and RFP proposals. The Analyst, under the direction and supervision of the Provider Services leadership, is responsible for maintaining a competitive and market leading MAC program and tracking pharmacy performance. The Analyst will also be responsible for managing and responding to pharmacy pricing inquiries in compliance with Navitus response protocol. This position will help monitor and evaluate state MAC requirements to ensure Navitus remains compliant with MAC management and inquiry. The Analyst will assist in working with internal and external partners including pharmacies, clients, vendors, and internal department liaisons to implement and maintain an effective MAC program.

 

Is this you? Find out more below!

Responsibilities

How do I make an impact on my team? 

• Operation and timely administration of the Navitus generic pricing programs including MAC, NADAC, or other pricing structures, which includes determining products to be included on the MAC list and the associated price per unit and updating all pricing within Navitus systems.
• Responsible for fielding, analyzing, and resolving inquiries from pharmacy providers, clients, and internal teams.
• May evaluate state MAC requirements to ensure Navitus MAC management remains compliant.
• May manage quarterly and yearly pharmacy performance and/or reconciliations.
• Monitor industry events to determine availability of generic introduction to the marketplace and manage exclusivity timeline for newly introduced generics.
• Manage consolidation of generic manufacturers in the market that will affect MAC pricing.
• Continuously review and proactively identify areas of opportunities for pricing and discount performance improvement, including analysis and communication of reimbursement activities.
• Research customer and contract issues that may affect account planning, strategies, and proposals. Assists with RFP responses as necessary.
• Periodic and detailed reporting of activities and opportunities to Provider Services team and cross-functional leadership.
• Research external and internal pricing trends and opportunities to contribute to overall pricing strategy.
• Perform analyses as requested by internal an