Navitus

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.

USD $52,656.00 - USD $72,716.00 /Yr.

M-F 8am-5pm

Job Summary:

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 Analyst 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. 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.

Job Responsibilities:

• 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.
• Understand, follow, and assist with improvements to current operational and administrative processes. 
• Evaluate state MAC requirements to ensure Navitus MAC management remains compliant.
• 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 pro-actively identify areas of opportunities for pricing and discount performance improvement, including analysis and communication of reimbursement activities.
• Make decisions regarding the resolution of pharmacy issues. 
• Research customer and contract issues that may affect account planning, strategies, and proposals. Assists with RFP responses as necessary.
• Develop and execute effective communication vehicles to disseminate accurate and concise information to network providers.
• 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 and external business owners, or in support of identified business objectives, with special focus on pharmacy network profitability and/or client discounts.
• Develop understanding of contractual terms and performance to assist in developing and enhancing network strategies, pricing decisions, and contract language.
• Identify, advocate, and implement continual process improvement of policies and procedures to maximize quality and efficiencies.
• Perform quality assurance to ensure accuracy in pricing and processes and share results with leadership.
• Assist with internal department and corporate projects as required.
• Solve moderately complex problems.
• Other related duties as assigned/required.

Job Qualifications:

• Ideal candidate will be detailed and well-organized, with both interpersonal and analytical skills, and can manage multiple priorities.
• Ability to professionally interact with providers and/or clients at all levels of the organization (both internal and external) is required.
• Ability to retrieve and analyze large sets of data to aid in pricing decision making.
• Must be able to function independently while also working closely with individuals within other departments. 
• Candidate must rely on knowledge of Navitus’ business concepts, practices, and procedures to accomplish goals.
• Ability to prioritize work to meet a need.
• Strong team orientation and the ability to work with a variety of people.
• Excellent verbal and written communication as well as strong organizational skills.
• Able to take direction to meet departmental objectives.
• PC skills: Microsoft Excel, Access, and other applications as required.

Essential Background Requirements: 

• Education: Bachelor’s degree required. Emphasis in business, finance, economics, or actuarial science strongly preferred. Recent college graduates are encouraged to apply.

Key Skills/Competencies:

• Extensive analytical skills.
• Ability to research, analyze and problem solve. 
• Detail oriented.
• Judgment and Decision-making.
• Ability to build and manage relationships
• Basic understandings of overall business risk to company.
• Self-starter who can work independently. 
• Prepare and execute project management documents.
• High level communication skills (written, verbal/presentation and active listening).
• Ability to work independently and prioritize work to meet Navitus’ and clients’ needs.
• Collaborative team building.
• Understand the sense of urgency to complete the job.
• Absolute and uncompromising integrity with the ability to instill trust, integrity, fairness, credibility, and a sense of urgency.
• Ability to multi-task in a fast environment with minimum supervision.
• The ability to consistently interact cooperatively and respectfully with other employees