Pharmacy Contract Audit Analyst

Navitus Health Solutions

. Oversee Navitus’ contractual pharmacy network reimbursement accuracy .

Posted 9/21/2026full-timeRemote • United StatesJuniorMid-Level💰 $54,236 - $64,567 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates strong analytical skills and operational understanding of pharmacy reimbursement programs, including the ability to interpret contract language and ensure compliance with contractual obligations. Proficient in developing controls and oversight reporting while effectively communicating findings to cross-functional teams.

Highest-signal resume keywords

Pharmacy Network Reimbursement AccuracyAnalytical ExperienceContractual ComplianceNavitus Adjudication System (NCRx)Pharmacy Network Rate Testing

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

AnalyticsContract InterpretationPricing Structure AnalysisOversight ReportingClaims Data ReviewNetwork Performance AnalysisRoot Cause AnalysisProcess ImprovementCompliance MonitoringImpact Assessment

Soft Skills

Cooperative InteractionRespectful CommunicationDecision-Making

Tools & Technologies

NCRxPC2

Industry Keywords

Retail PharmacySpecialty PharmacyMail Order PharmacyAWPWACMACNADACFULAACAverage Dispensing Fee

About the role

Key responsibilities & impact

Oversee Navitus’ contractual pharmacy network reimbursement accuracy
Independently assess compliance with contractual reimbursement obligations in Retail, Specialty, and Mail Order pharmacy agreements
Review and monitor claims data
Create and update procedures
Audit networks for price change accuracy
Monitor compliance with pharmacy provider contracts
Communicate findings and work with applicable teams to remediate errors
Interpret contractual terms, client network selections, and their operationalization in applicable systems
Utilize Navitus’ adjudication system (NCRx) and contracting and credentialing databases (PC2), among other applications
Analyze provider, client, and network performance for network development, quality control, and contractual compliance
Create reports validating systems accuracy against Retail, Specialty, and Mail Order contractual terms
Field, analyze, and resolve pricing-error inquiries from pharmacy providers, clients, auditors, and internal teams, focusing on root cause
Develop and maintain controls and oversight reporting for contract pricing
Identify, define, and implement new processes when controls are absent
Conduct pharmacy network rate testing, chain audits, and impact assessments
Submit service requests and recovery requests and engage applicable teams for system updates or changes
Report contractual compliance activities and opportunities to the Provider Services team and cross-functional leadership
Perform other duties as assigned

Requirements

What you’ll need

Bachelor’s degree or equivalent experience required
Emphasis in business, finance, economics, or operations preferred
Minimum two years analytics experience required
Analytical and operational understanding of Navitus’ reimbursement programs including AWP, WAC, MAC, NADAC, FUL, AAC, Average Dispensing Fee, and other pricing structures
Ability to interpret pharmacy contract language and compare contract pricing to adjudicated claims activity
Ability to develop and maintain controls and oversight reporting
Ability to perform pharmacy network rate testing, chain audits, analysis, and impact assessment
Ability to make decisions regarding pharmacy network pricing setup issues
Ability to understand, follow, and improve operational and administrative processes
Ability to participate in, adhere to, and support compliance program objectives
Ability to consistently interact cooperatively and respectfully with other employees
Ability to work remotely from an eligible US state; remote work unavailable to residents of Alaska, Hawaii, Maine, Mississippi, New Hampshire, New Mexico, North Dakota, Rhode Island, South Carolina, South Dakota, West Virginia, and Wyoming

Benefits

Comp & perks

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!
M-F 8:00am-5:00pm schedule