Manager, Pharmacy Network Reporting - Remote

at  Navitus Health Solutions LLC

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. Pay Range: USD $93,000.00 - USD $114,000.00 /Yr. Work Schedule Description (e.g. M-F 8am to 5pm): M-F Core Business Hours Overview:

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.
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 Manager, Pharmacy Network Reporting will oversee and manage the Pharmacy Network Reporting Team. The position will support the Navitus Network Contracting, Sales, Account Management, Implementation, and Government Programs departments, as well as the Navitus pharmacy network contract pricing and reporting requirements. The Manager will oversee and lead Navitus Network Contracting Analysts, Network Reporting, and the Navitus MAC Team to ensure the success of business needs and contract compliance. The individual will leverage the use of analytics to assist internal customers in making informed decisions, increase Navitus’ sales and marketing opportunities, and serve as the Provider Services’ primary subject matter expert on Network Contracting and Network Reporting. This individual will understand and interpret data from the Navitus data warehouse, the Navitus claims adjudication system, pharmacy network databases, NCPDP pharmacy files, Medi-Span files, pharmacy acquisition cost market intel, and other data sources required to facilitate the successful delivery of information. This position enhances departmental efficiency through Qlikview development and network database improvements. The individual in this position will demonstrate competence in using multiple informatics tools, including MS Office products, Quest Analytics, Qlikview, Blue Relay, and other software tools. The person in this role will be a data expert with extensive knowledge of Navitus data models, data sources, and data attributes, especially regarding pharmacy networks and pharmacy claims.
The Manager deeply understands pharmacy reimbursement methodologies and generic drug pricing. The individual will support and advise senior leadership regarding provider agreements, administration of the MAC Program, and network adequacy. The Pharmacy Network Reporting team supports and evaluates agreements with providers through financial price modeling, analysis, and reporting and will play a key role in network contracting strategy. The Manager is responsible for maintaining and managing a competitive, market-leading MAC Program, including working with pharmacies, clients, vendors, and internal department liaisons to implement and maintain a compliant MAC Program. This position oversees the monitoring and maintaining Navitus’s generic effective rate and other contractual requirements with applicable providers to facilitate adjustments in Navitus’ adjudication system to meet contractual terms, which requires a fundamental understanding of the Navitus adjudication system and operational processes.
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