Director, PBM Network Pricing & Market Planning

Company: Navitus About Us: Navitus - Putting People First in Pharmacy - Navitus was founded as an alternative to traditional pharmacy benefit manager (PBM) models. We are committed to removing cost from the drug supply chain to make medications more affordable for the people who need them. At Navitus, our team members work in an environment that celebrates diversity, fosters creativity and encourages growth. We welcome new ideas and share a passion for excellent service to our customers and each other._____________________________________________________________________________________________________________________________________________________________________________________________________________. Current associates must use SSO login option at https://employees-navitus.icims.com/ to be considered for internal opportunities. ____________________________________________________We are committed to providing equal employment opportunity to all applicants and employees and comply with all applicable nondiscrimination regulations, including those related to protected veterans and individuals with disabilities. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, or handicap. Pay Range: USD $142,128.00 - USD $177,660.00 /Yr. STAR Bonus % (At Risk Maximum): 15.00 - Director, GM of GP, PIC Work Schedule Description (e.g. M-F 8am to 5pm): M-F 8am-5pm Remote Work Notification: ATTENTION: 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:

Due to continued growth, we are adding an experienced leader with deep Pharmacy Benefit Management (PBM) expertise and a strong background in pharmacy reimbursement, network pricing, and Maximum Allowable Cost (MAC) pricing strategies to our growing team. The ideal candidate brings a proven track record of translating complex pharmacy pricing and contracting structures into measurable financial performance, with experience overseeing effective rate guarantees, reimbursement analytics, and pricing governance. This role is critical to ensuring that network pricing strategies are operationalized effectively and deliver expected outcomes across all lines of business.

The Director, Network Pricing & Market Planning is responsible for owning pharmacy network financial performance across all lines of business, with direct accountability for achieving contracted reimbursement guarantees, including effective rate (BER/GER) performance and MAC pricing outcomes.

The Director, Network Pricing & Market Planning is responsible for owning pharmacy network financial performance across all lines of business, with direct accountability for achieving contracted reimbursement guarantees, including effective rate (BER/GER) performance and MAC pricing outcomes. This role leads the Network Reconciliation and MAC Pricing teams and is accountable for ensuring that contracted pharmacy rates are operationalized, monitored, and achieved. The Director focuses on performance execution—translating network pricing strategies into realized financial outcomes through rigorous reconciliation, variance management, and pricing intervention.

The Director partners with Network Contracting, Underwriting, Finance, and Analytics leadership to ensure alignment between contracted terms and financial outcomes. Unlike strategy or informatics roles, this position is accountable for post-contract performance realization—owning the processes, teams, and controls that ensure pharmacy reimbursement aligns with contractual expectations. This includes reconciliation oversight, effective rate compliance, MAC performance, and corrective action when performance deviates.

Is this you? Find out more below!

Responsibilities:

How do I make an impact on my team?

Network Performance Ownership & Reconciliation Leadership

• Lead the Network Reconciliation function with full accountability for validating pharmacy network performance against contracted effective rates (BER/GER) and pricing guarantees.
• Own reconciliation outcomes across all li…