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 Provider Services Support Specialist is responsible for supporting Retail, Specialty and Mail initiatives in coordination with the Provider Services team. This position will be the primary resource for internal teams and will assist in responding to Retail, Specialty and Mail pharmacy inquiries from Account Management, Implementation, Provider Services and other Navitus departments as needed. This position will be proficient in the analysis of Navitus claims and supplementary pharmacy data to support reporting and contract compliance.

The individual will be expected to understand and interpret data, including claims utilization from Navitus' data warehouse and from NCRx, formulary files, pharmacy network databases, NCPDP pharmacy files, Medispan files, and other databases required from time-to-time to facilitate and ensure the accurate delivery of information related to client and pharmacy partner reporting requirements. This position will also support Navitus client inquiries regarding contractual issues, including internal and external contacts regarding pharmacy participation, pharmacy services, and network discounts. This position requires independent judgment capabilities, strong communications skills, the ability to coordinate multiple requests in an organized manner, regularly exercises discretionary powers and maintains an in-depth knowledge in the Retail, Specialty and Mail pharmacy industry and stays up to date with industry trends and changes.

Is this you? Find out more below!

How do I make an impact on my team?

• Primary resource within department for Retail, Specialty, and Mail pharmacy opportunities, client requests for potential network opportunity evaluations, and assists teams in evaluation and assessments of current clients' pharmacy network performance, current industry trends, performance, and initiatives.
• Serve as the primary representative for Provider Services during new client implementation, including the review and refinement of existing processes.
• Ability to read and interpret Network contracts to facilitate Network design recommendations for clients.
• Review and analyze Navitus claims data and clinical data from Retail, Mail and Specialty pharmacy partners to develop and improve pharmacy reporting packages for Navitus departments and clients.
• Coordination with pharmacy partners to ensure contractual compliance with terms of Specialty pharmacy contracts including performance guarantees, financial and services terms.
• Responsible for the use of databases to generate pharmacy reports for clients, pharmacies, and internal customers, and identification of ways to improve and/or automate generation of these reports.
• Develop understanding of contractual terms and performance to assist in developing and enhancing network strategies for Navitus clients.
• Responsible for fielding and resolving inquiries from internal teams and clients.
• Research customer and contract issues that may affect account planning, strategies, and proposals.
• Continually monitor pharmacy network programs to meet all government regulations and statutes, and client guarantees in performance of our services.

What our team expects from you?

• Bachelor's degree is required with concentration in Business preferred
• Two-three years business experience in a related industry (pharmacy or PBM) is preferred.
• Pharmacy technician certification is a plus.
• At least 1 year experience in business, finance or economics is preferred.
• 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-Remote
• 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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