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 $62,686.00 /Yr.

M-F 8am-5pm, CST

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.

Due to growth we are seeking a Provider Services Support Specialist to join our Provider Services team!

 

The Provider Services Support Specialist is responsible for supporting Retail, Specialty and Mail initiatives in coordination with the Provider Services team. This position will be proficient in the analysis of Navitus claims and supplementary pharmacy data to support reporting and contract compliance. The Provider Services Support Specialist supports and evaluates agreements with providers and prospective clients via analysis, and reporting. This individual will also act as subject matter expert on pharmacy networks, programs and inquiries via the collection, processing, research, response and/or triage of requests and will represent the Provider Services Department in all client meetings, as applicable. The Provider Services Specialist, under the direction and supervision of Provider Services leadership, is responsible for evaluating pharmacy participation agreements to maximize pharmacy discounts in a consulting capacity with current and new Navitus clients. The position will support internal and client provider services communications, service inquiry responses, and program requirements with clients and pharmacy partners to ensure Navitus is meeting applicable program obligations. The individual will be expected to understand and interpret data, including claims utilization from Navitus’ data warehouse and from NCRx, formulary files, pharmacy network databases, NCPDP pharmacy files, Medispan files, and other databases required from time-to-time to facilitate and ensure the accurate delivery of information related to client and pharmacy partner reporting requirements. This position will also support Navitus client inquiries regarding contractual issues, including internal and external contacts regarding pharmacy participation, pharmacy services, and network discounts.

 

Is this you? Find out more below!

How do I make an impact on my team? 

• Primary resource within department for Retail, Specialty, and Mail pharmacy opportunities, client requests for potential network opportunity evaluations, and assists teams in evaluation and assessments of current clients’ pharmacy network performance, current industry trends, performance, and initiatives
• Serve as the primary representative for Provider Services during new client implementation, including the review and refinement of existing processes
• Ability to read and interpret Network contracts to facilitate Network design recommendations for clients
• Review and analyze Navitus claims data and clinical data from Retail, Mail and Specialty pharmacy partners to develop and improve pharmacy reporting packages for Navitus departments and clients
• Coordination with pharmacy partners to ensure contractual compliance with terms of Specialty pharmacy contracts including performance guarantees, financial and services terms
• Responsible for the use of databases to generate pharmacy reports for clients, pharmacies, and internal customers, and identification of ways to improve and/or automate generation of these reports
• Research customer and contract issues that may affect account planning, strategies, and proposals
• Continually monitor pharmacy network programs to meet all government regulations and statutes, and client guarantees in performance of our services
• Other duties as assigned

What our team expects from you?

• Bachelor’s degree is required with concentration in Business preferred
• Two–three years business experience in a related industry (pharmacy or PBM) is preferred
• Pharmacy technician certification is a plus
• At least 1 year experience in business, finance or economics is preferred
• 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.

Remote

US