Director, PBM Pharmacy Network Contracting

Navitus Health Solutions

Director of Pharmacy Network Contracting at Navitus responsible for negotiating pharmacy contracts. Leading strategies to ensure competitive reimbursement and regulatory alignment.

Posted 6/6/2026full-timeRemote • Idaho • 🇺🇸 United StatesLead💰 $142,128 - $177,660 per yearWebsite

About the role

Key responsibilities & impact

Lead negotiation of pharmacy participation agreements across all provider segments, including national chains, grocers, PSAOs, and independent pharmacy networks.
Own reimbursement structures, contract terms, and financial outcomes of pharmacy provider agreements.
Establish negotiation strategies that balance market competitiveness with enterprise financial and network performance goals.
Serve as the decision-maker for contract structure, rate positioning, and escalated negotiation decisions.
Approve contract exceptions and ensure alignment to broader network strategy and pricing objectives.
Provide strategic leadership over 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.
Lead provider engagement strategy to support successful contract negotiations, alignment to contract intent, and long-term network stability.
Ensure negotiated contract terms are clearly defined, documented, and positioned for accurate downstream implementation.
Partner with Network Operations and Performance teams to support effective handoff, implementation, and validation of contract terms.
Act as escalation point for complex, high-risk, or systemic contract issues requiring higher-level leadership intervention.

Requirements

What you’ll need

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

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!

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

provider contractingcontract strategypharmacy reimbursementclaims adjudicationnegotiation strategiescontract governancecontract standardsfinancial outcomespricing strategiescontract implementation

Soft Skills

strategic leadershipteam developmentinterpersonal skillsdecision-makingcollaborationcommunicationproblem-solvingnegotiationadaptabilityconflict resolution