Navitus Health Solutions logo
Navitus Health Solutions

We are committed to helping humans by making medications more affordable for the people who need them.

Director, PBM Specialty Pharmacy Network Contracting

PharmacistPharmacistFull TimeRemoteLeadTeam 1,001-5,000Since 2003H1B No SponsorCompany SiteLinkedIn

Location

Idaho

Posted

7 days ago

Salary

$142.1K - $177.7K / year

Seniority

Lead

Bachelor Degree7 yrs expEnglish

Job Description

Director, PBM Specialty Pharmacy Network Contracting

Navitus Health Solutions

• Lead negotiation of specialty pharmacy participation agreements across all provider segments, including national chains with specialty capabilities, independent specialty pharmacies, and health system–affiliated providers. • Own reimbursement structures, contract terms, and financial outcomes for specialty pharmacy agreements, including high-cost drug categories. • Establish negotiation strategies that balance market competitiveness, provider sustainability, and enterprise financial objectives within the specialty drug landscape. • Serve as the decision-maker for contract structure, rate positioning, and escalated negotiation decisions. • Approve contract exceptions and ensure alignment to broader specialty network and enterprise strategy. • Provide strategic leadership over specialty pharmacy participation agreements, network addenda, and contract standards, ensuring consistency with enterprise pricing, access, and compliance objectives. • Develop and maintain contracting playbooks, standards, and governance frameworks to support scalable and consistent negotiation practices. • Guide contract structure decisions to support evolving pricing strategies, regulatory changes, and market dynamics. • Recommend enhancements to contract language and structure to improve clarity, enforceability, and long-term sustainability. • Lead specialty provider engagement strategy to support successful contract negotiations, alignment to contract intent, and long-term network stability.

Job Requirements

  • Bachelor’s degree in Business, Finance, Economics, or Healthcare Administration, or related field, or equivalent work experience, required.
  • 7+ years of progressive PBM, healthcare plan, pharmacy network, or equivalent experience required.
  • Demonstrated experience in provider contracting, contract strategy, or network governance required.
  • Strong understanding of pharmacy reimbursement and claims adjudication concepts 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.
  • 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!

Related Categories

Related Job Pages

More Pharmacist Jobs

ExactCare logo

Senior Pharmacy Technician

ExactCare

A national medication management and long-term pharmacy provider for people with complex, chronic needs

Pharmacist7 days ago
Full TimeRemoteTeam 501-1,000Since 2009H1B No Sponsor

• Act as a subject matter expert in assigned task(s) and/or functions • Providing an exceptional customer service experience each day in a phone-based environment • Enter a high volume of data; processing prescription information with speed and accuracy • Utilizing sound drug knowledge to effectively receive prescription authorizations, clarifications or transfers • Perform claim adjudication and auditing duties such as prior authorizations, billing and eligibility checks • Requiring outbound calls to patients • Working through current case queues to problem-solve for patient care issues • Serving as a liaison between the clinical pharmacists and other medical professionals on patients’ behalf • Partner with technicians and pharmacists to ensure that new patients are successfully onboarded to ExactCare • Maintaining patient records with strong attention to detail and confidentiality • Accurate retrieval of all prescription information and verifying through doctor calls • Placing welcome calls to newly onboarded patients and establish a trusted point of contact • Placing outbound calls to patients to create, maintain or update their medication profiles • Serve as backup support for times of higher patient call volume • Effectively assist with patient questions over the phone • Performing in a high volume, fast-paced environment to support ExactCare’s nationwide patient base • Embody AnewHealth’s Core Values in all communications and interactions • Other duties as assigned

Ohio
ExactCare logo

Lead Pharmacy Technician

ExactCare

A national medication management and long-term pharmacy provider for people with complex, chronic needs

Pharmacist7 days ago
Full TimeRemoteTeam 501-1,000Since 2009H1B No Sponsor

• The Pharmacy Technician Lead serves as the subject matter expert of their designated pharmacy team. • They will work alongside the Pharmacy Supervisors and Managers to drive and support department efficiencies. • In this role, the expectation is to lead by example and support company and department goals as well as demonstrate their ability to drive results and achieve a consistent standard of work from the team. • High level of contribution in front line, day to day work as assigned by leadership • Provide training on department tasks to new hires, cross trainees and existing team members requiring additional support • Help coordinate the completion of cross training through communication and scheduling with designated trainees • Provide a high level of subject matter expertise to the department in supporting continuous improvement projects including training guides and SOP development • Support leadership in diagnosing and improving performance of team members • Embody AnewHealth’s Core Values in all communications and interactions.

Ohio
ExactCare logo

Pharmacy Technician Lead

ExactCare

A national medication management and long-term pharmacy provider for people with complex, chronic needs

Pharmacist7 days ago
Full TimeRemoteTeam 501-1,000Since 2009H1B No Sponsor

• The Pharmacy Technician Lead serves as the subject matter expert of their designated pharmacy team. • They will work alongside the Pharmacy Supervisors and Managers to drive and support department efficiencies. • In this role, the expectation is to lead by example and support company and department goals as well as demonstrate their ability to drive results and achieve a consistent standard of work from the team. • High level of contribution in front line, day to day work as assigned by leadership. • Provide training on department tasks to new hires, cross trainees and existing team members requiring additional support. • Help coordinate the completion of cross training through communication and scheduling with designated trainees. • Provide a high level of subject matter expertise to the department in supporting continuous improvement projects including training guides and SOP development. • Support leadership in diagnosing and improving performance of team members. • Embody AnewHealth’s Core Values in all communications and interactions. • Other duties as assigned.

Ohio
CenterWell Home Health logo

Senior Integrated Clinic Pharmacist

CenterWell Home Health

CenterWell Home Health is one of the largest providers of home healthcare, hospice, and nonmedical personal care services in the United States. Formerly known a

Pharmacist8 days ago

Evaluate pharmacotherapy for high-risk patients, collaborate with healthcare professionals to optimize care, execute clinical protocols, and engage in quality improvement initiatives to enhance medication safety and efficacy.

Florida