Manage pharmacy contracting, contract redlines, network compliance, audits, pharmacy inquiries, claims issue resolution, communications, plan design builds, quality assurance, and claims processing. The role supports pharmacy network maintenance and government-regulatory compliance within a pharmacy benefit management environment.
CompanyNavitus
About UsNavitus - 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._____________________________________________________________________________________________________________________________________________________________________________________________________________. Current associates must use SSO login option at https://employees-navitus.icims.com/ to be considered for internal opportunities. ____________________________________________________We are committed to providing equal employment opportunity to all applicants and employees and comply with all applicable nondiscrimination regulations, including those related to protected veterans and individuals with disabilities. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, or handicap.
Pay RangeUSD $48,728.61 - USD $58,010.26 /Yr.
STAR Bonus % (At Risk Maximum)5.00 - Salaried Non-Management except pharmacists
Work Schedule Description (e.g. M-F 8am to 5pm) M-F 8am to 5pm
Remote Work NotificationATTENTION: Navitus is 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.
Overview
Navitus Health Solutions is seeking a Pharmacy Relations Specialist to join our team!
The Pharmacy Relations Specialist (PRS II) is a highly motivated professional with at least 2 years of successful experience working in a pharmacy or interfacing directly with pharmacies or accounts, preferably in healthcare. Responsibilities include executing contracts with pharmacies, responding to pharmacy inquiries, and completing the tactical and operational tasks required to maintain contracted pharmacy networks.
Is this you? Find out more below!
ResponsibilitiesHow do I make an impact on my team?
- Manage pharmacy contracting process with independent pharmacies and select chains/PSAOs and assist management with network negotiations; inclusive of redline reviews
- Review pharmacy contract setup to ensure compliance with pharmacy network agreements
- Support pharmacy audits and network compliance initiatives
- Research and problem solve to resolve claim issues and concerns
- Respond to and track requests, inquiries, and communications with network pharmacies
- Develop, review, and distribute pharmacy communications to meet internal and client requests
- Monitor, track, and report pharmacy compliance with guiding government regulations and internal policies and procedures
- Reviews and responds to independent pharmacy redlines; with little to no input from senior leadership
- Responsible for all aspects of maintenance related to pharmacy network functions, such as, network plan design builds, quality assurance measures and claims processing in general
- Other duties as assigned
What our team expects from you?
- College or 2-year Technical Degree or equivalent experience is preferred. Advanced technical education a plus
- Certified Pharmacy Technician preferred
- 3 years business-setting experience
- Retail pharmacy experience or experience in a managed care pharmacy setting desired
- Prior experience analyzing medical and/or pharmacy claims or credentials are highly desired
- Proficient in Microsoft Office and industry related software
- Participate in, adhere to, and support compliance program objectives
- The ability to consistently interact cooperatively and respectfully with other employees
What can you expect from Navitus?
- 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!
#LI-Remote
Location : AddressRemote Location : CountryUSNavitus Health Solutions Austin, Texas, USA Office
7501 N Capital Of Texas Hwy, Building C, Suite 200, Austin, TX, United States, 78731
Similar Jobs
Artificial Intelligence • Cloud • Information Technology • Machine Learning • Software • Big Data Analytics • Automation
Owns a defined territory of mid-sized customer accounts, driving revenue expansion through upselling, cross-selling, consultative selling, and executive engagement. Develops territory and account plans, identifies growth opportunities, manages Salesforce pipeline forecasts, promotes PagerDuty Operations Cloud adoption, and collaborates with solution consultants, customer success, renewals, and product teams. Requires B2B SaaS sales experience, quota attainment, C-level selling skills, and familiarity with Salesforce and complex sales methodologies.
Top Skills:
Pagerduty Operations CloudSalesforce
Artificial Intelligence • Cloud • Information Technology • Machine Learning • Software • Big Data Analytics • Automation
Owns a territory of mid-sized SaaS customer accounts, driving expansion through upselling, cross-selling, consultative selling, and executive engagement. Responsibilities include developing territory and account plans, identifying growth opportunities, managing Salesforce pipeline forecasts using MEDDICC, increasing Operations Cloud adoption, and collaborating with solution consultants, customer success, renewals, and product teams. The role requires 3–5 years of B2B SaaS or enterprise software sales experience and is based in a hybrid San Francisco location.
Top Skills:
DevOpsPagerduty Operations CloudSalesforce
Artificial Intelligence • Cloud • Information Technology • Machine Learning • Software • Big Data Analytics • Automation
Own and expand a portfolio of enterprise accounts through upselling, cross-selling, consultative selling, and complex multi-product SaaS deals. Build executive relationships, create strategic account plans, articulate business value and ROI, manage forecasts and Salesforce pipeline using MEDDICC, and collaborate with solution consultants, customer success, product, and renewals teams to drive adoption, retention, and growth.
Top Skills:
Cloud SoftwareDevOpsOperations CloudSaaSSalesforce
What you need to know about the Austin Tech Scene
Austin has a diverse and thriving tech ecosystem thanks to home-grown companies like Dell and major campuses for IBM, AMD and Apple. The state’s flagship university, the University of Texas at Austin, is known for its engineering school, and the city is known for its annual South by Southwest tech and media conference. Austin’s tech scene spans many verticals, but it’s particularly known for hardware, including semiconductors, as well as AI, biotechnology and cloud computing. And its food and music scene, low taxes and favorable climate has made the city a destination for tech workers from across the country.
Key Facts About Austin Tech
- Number of Tech Workers: 180,500; 13.7% of overall workforce (2024 CompTIA survey)
- Major Tech Employers: Dell, IBM, AMD, Apple, Alphabet
- Key Industries: Artificial intelligence, hardware, cloud computing, software, healthtech
- Funding Landscape: $4.5 billion in VC funding in 2024 (Pitchbook)
- Notable Investors: Live Oak Ventures, Austin Ventures, Hinge Capital, Gigafund, KdT Ventures, Next Coast Ventures, Silverton Partners
- Research Centers and Universities: University of Texas, Southwestern University, Texas State University, Center for Complex Quantum Systems, Oden Institute for Computational Engineering and Sciences, Texas Advanced Computing Center
