Coordinator, Pharmacy Relations

Job Description

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.

Due to growth, we are adding this Pharmacy Relations Coordinator to our Provider Services department.

The Pharmacy Relations Coordinator (PRC) 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.

The individual(s) in this position are responsible for superior customer service with pharmacy partners and is the face of Navitus to our pharmacy partners. The individual(s) will also support internal associates, such as customer care and client services, to ensure pharmacies adjudicate pharmacy claims according to Navitus agreements and Navitus business rules. As part of the daily responsibilities, this position is responsible for establishing contracts with pharmacy providers, recording data with a high level of accuracy, researching pharmacy inquiries, and reporting performance metrics. In addition, the coordinator develops efficiencies in current and future processes within the department and in how the department works with other Navitus teams.

Is this you? Find out more below!

How 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

Review pharmacy contract setup to ensure compliance with pharmacy network agreements

Support pharmacy audits and network compliance initiatives

Support daily contracting operations

Implement changes to ensure compliance with all company policies and procedures as well as regulatory requirements

Develop, review, and distribute pharmacy communications to meet internal and client requests

Investigate specific issues related to regulatory requirements through literature or internet resources

Monitor, track, and report pharmacy compliance with guiding government regulations and internal policies and procedures

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

Maintain a thorough understanding of all implications of adjudication platform changes while coordinating accordingly with all upstream and downstream stakeholders

What our team expects from you?

High school or equivalent, advanced degree preferred. CPhT preferred.

1-3 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.

Ideal candidate will be able to work independently, have telephonic and written communication skills, data-mine variable databases, analytical skills, and can manage multiple priorities.

Ability to professionally interact with professionals at all levels (both internal and external) is required.

Must be able to function independently, however work closely with individuals within other departments.

Candidate must be proficient in Microsoft applications.

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?

Hours/Location: Monday-Friday 8:00am-5:00pm CST, Hybrid, 2 days in Madison WI Office or Appleton WI Office

Paid Volunteer Hours

Educational Assistance Plan and Professional Membership assistance

Referral Bonus Program – up to $750!

Top of the industry benefits for Health, Dental, and Vision insurance, Flexible Spending Account, Paid Time Off, Nine paid holidays, 401K, Short-term and Long-term disability, College Savings Plan, Paid Parental Leave, Adoption Assistance Program, and Employee Assistance Program

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