Company

Navitus Health Solutions LLCSee more

addressAddressAppleton, WI
type Form of workFull-Time
CategoryInformation Technology

Job description

Job Description

Are you a finance, accounting, business, or actuarial science professional looking for work life balance and great benefits? Look no further because here we grow again! We are adding a Network Contracting Analyst to our Provider Services department.


What can you expect from Navitus?

  • Remote-first employer
  • Paid Volunteer Hours
  • Low deductible health plans plus Dental, Vision, Flexible Spending Account, Paid Time Off, Nine paid holidays, Short-term and Long-term disability, College Savings Plan, Paid Parental Leave, Adoption Assistance Program, and Employee Assistance Program
  • 401(k) matching with immediate vesting
  • Educational Assistance Plan and Professional Membership assistance
  • Referral Bonus Program – up to $750!

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.

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, including national and regional chain providers, pharmacy services administration organizations (PSAOs) and independent pharmacies for all lines of business.

The Network Contracting Analyst will analyze contract alternatives to support Network Contracting retail and specialty teams and lead analysis of negotiated contracts to maximize return and mitigate risks. The Network Contracting Analyst will provide clear data summaries to explain reimbursement, network needs, and industry trends to support pharmacy and vendor contract negotiations across all lines of business and geographies (Commercial, Medicare and managed Medicaid). This position will be expected to work cross functionally with internal and external partners including clients, vendors, and pharmacy partners to deliver value to Navitus clients through our pharmacy contracts.

Is this you? Find out more below!

How do I make an impact on my team?

  • 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.
  • Collaborate with Contract Managers, Finance, and other internal business divisions to make recommendations to financial models.
  • 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.
  • Complete ad hoc analyses and assist with special projects as directed by retail and specialty supervisors.
  • 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; collaborating cross-functionally to make effective business decisions; escalating high priority issues and risks as appropriate; and recognizing and capitalizing on network management improvement opportunities.
  • Interface with the Pharmacy Network Analytics team to communicate updated network pricing and network design changes.

What our team expects from you?

  • 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, but we are willing to train you on our industry!
  • 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

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.

Refer code: 7234558. Navitus Health Solutions LLC - The previous day - 2023-12-18 03:56

Navitus Health Solutions LLC

Appleton, WI
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