Navitus Health Solutions

Navitus Health Solutions is a group that seeks to make medications more affordable so that people can experience better health. It utilizes a 100% pass-through

Director, Network Informatics, Analytics

Location

Idaho

Posted

3 days ago

Salary

$152.1K - $190.1K / year

Seniority

Lead

Bachelor Degree7 yrs expExperience acceptedEnglish

Job Description

Director, Network Informatics, Analytics

Navitus Health Solutions

• Own and evolve the informatics framework supporting pharmacy network contracting, including contract attributes, reimbursement methodologies, network hierarchies, and provider identifiers • Establish and maintain data standards, definitions, and governance controls to ensure data consistency, usability, and integrity across systems and reporting environments • Serve as the centralized authority for network and contract data quality, enabling reliable and scalable analytics • Design and develop network models to evaluate reimbursement structures, pricing strategies, and financial impact across pharmacy segments • Build analytical frameworks to assess provider cost, performance, and value (e.g., scorecards, cost-of-care, network efficiency) • Identify optimization opportunities through scenario modeling, trend analysis, and performance insights • Lead development and maintenance of standardized reporting and dashboards for network performance, reimbursement trends, and contract alignment • Deliver actionable insights through routine and ad hoc analyses, including trend identification, outlier detection, and emerging risk monitoring • Establish KPI frameworks to measure network effectiveness, cost efficiency, and overall performance across pharmacy segments • Establish and oversee analytical quality control frameworks to assess alignment between contract intent and observed claims and network performance outcomes • Develop monitoring approaches that surface discrepancies, emerging risks, or unintended financial impacts • Provide analytical insight into the performance of new network builds, contract changes, and reimbursement updates through evaluation of claims outcomes and network performance • Collaborate with Analytics, Finance, IT, Compliance, Legal, and Operations to ensure data transparency, alignment, and visibility into key issues • Support enterprise initiatives including new client implementations, regulatory changes, and network expansion strategies

Job Requirements

  • Bachelor’s degree in Business, Finance, Analytics, Information Systems, Healthcare Administration, or related field, or equivalent work experience, required.
  • 7+ years of progressive experience in PBM, healthcare analytics, PBM network operations (not IT networks), pharmacy informatics or equivalent experience required.
  • 3+ years of leadership experience with a proven ability to develop high-performing teams and deliver tangible results in a professional services environment required.
  • Demonstrated experience with claims data, network configuration, reimbursement models, and complex data environments required.
  • Proven ability to lead analytics, reporting, or informatics functions in a regulated healthcare setting required.
  • Experience supporting contracting, pricing, or network management functions strongly preferred.
  • Participate in, adhere to, and support compliance program objectives.
  • The ability to consistently interact cooperatively and respectfully with other employees.

Benefits

  • 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!

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