Specialist II, Pharmacy Relations
Navitus Health Solutions, Madison, WI, United States
Specialist II, Pharmacy Relations
Location: United States (Remote: Yes)
ID: 2026-5697
Job Details Category: Administration. Position Type: Full-Time. Remote: Yes.
Pay & Compensation Pay Range: USD $47,309.00 - $56,321.00 per year.
STAR Bonus % (At Risk Maximum): 5.00% (Salaried Non-Management except pharmacists).
Work Schedule M-F 8:30am-5pm
Remote Work Notification 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 (PRS II) 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!
Responsibilities 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; 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
Qualifications 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
Benefits 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
#J-18808-Ljbffr
ID: 2026-5697
Job Details Category: Administration. Position Type: Full-Time. Remote: Yes.
Pay & Compensation Pay Range: USD $47,309.00 - $56,321.00 per year.
STAR Bonus % (At Risk Maximum): 5.00% (Salaried Non-Management except pharmacists).
Work Schedule M-F 8:30am-5pm
Remote Work Notification 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 (PRS II) 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!
Responsibilities 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; 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
Qualifications 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
Benefits 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
#J-18808-Ljbffr