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Role Description

Navitus Health Solutions is seeking a Network Contracting Analyst to join our team! The Analyst, Network Contracting will be responsible for the financial management of retail, specialty, and mail order pharmacy contracting, issue management, and reporting, in support of the network strategy to deliver value to Navitus clients. The primary responsibilities of this role are to:

• Analyze current and new pharmacy contracts and provide support for all phases of the pharmacy contracting process.
• Analyze contract alternatives to support Network Contracting retail and specialty teams.
• Lead analysis of negotiated contracts to maximize return and mitigate risks.
• Provide clear data summaries to explain reimbursement, network needs, and industry trends.
• Work cross-functionally with internal and external partners including clients, vendors, and pharmacy partners.

Responsibilities

• Support the network contracting management division by preparing contracting and strategy analytics, including new contracts and contract renewals.
• Prepare analyses covering provider agreements, 340B opportunities, mail order, discount card, specialty, and any related needs.
• Complete complex analysis to monitor the value of contracts and strategic initiatives of Navitus.
• Prepare forward-looking network analytics, ensuring alignment of planned actions and targets in the forecast.
• Proactively monitor industry trends including acquisition cost, competitive intel, and innovative program offerings.
• Support network management leaders in the development and analytical review of quarterly forecasting, annual planning, and multi-year contracting development and multi-year financial modeling.
• Advise internal stakeholders on strategic fiscal matters related to pharmacy financial management throughout the organization.
• Participate in regular meetings with leadership to review financial results and act as an internal consultant on interpreting financial results, analyzing variances and improving contracting performance.
• Support pharmacy contract negotiations by monitoring and delivering impact analysis of suggested pricing revisions.
• Support the development of work plans to meet provider and client business priorities and deadlines.
• Collaborate cross-functionally to make effective business decisions; escalate high priority issues and risks as appropriate.
• Recognize and capitalize on network management improvement opportunities.
• Interface with the Pharmacy Network Analytics team to communicate updated network pricing and network design changes.
• Other duties as assigned.

Qualifications

• Bachelor’s degree in finance, accounting, business, actuarial science or related field is preferred.
• At least one year of database management experience.
• Experience in business, finance, or analytics.
• Experience in Retail Pharmacy and/or Pharmacy Benefit Management (PBM) or Managed Care preferred.
• Familiarity with the Pharmacy Benefit Management (PBM), contracting and pharmacy industry/technical terms, pricing and processes preferred.
• Experience with CMS, Medicare, and state Medicaid regulations and guidance preferred.
• Knowledge of health care processes and pharmaceutical claims adjudication systems preferred.
• Participate in, adhere to, and support compliance program objectives.
• The ability to consistently interact cooperatively and respectfully with other employees.

Benefits

• Top of the industry benefits for Health, Dental, and Vision insurance.
• 20 days paid time off.
• 4 weeks paid parental leave.
• 9 paid holidays.
• 401K company match of up to 5% - No vesting requirement.
• Adoption Assistance Program.
• Flexible Spending Account.
• Educational Assistance Plan and Professional Membership assistance.
• Referral Bonus Program – up to $750!