[Remote] Sr. Analyst, Government Pricing

Note: The job is a remote job and is open to candidates in USA. Navitus Health Solutions is committed to making medications more affordable through innovative pharmacy benefit management. The Sr. Analyst, Government Pricing will provide advanced analytical support for Medicaid pharmacy programs, focusing on pricing methodologies and regulatory impacts to aid in decision-making and program strategy.ResponsibilitiesSupports the development and maintenance of Medicaid Fee-for-Service pharmacy pricing and modeling aligned with the company’s mission, strategies, products, and servicesOversee core analytical work related to SOW requirements, including, Medicaid MAC pricing analysis, and 340B program impacts and compliance considerationsDevelop, maintain, and enhance cost analysis and predictive trending models to support Medicaid FFS programs, segmented by SOW, pricing methodology, or program initiativeLead and manage the capture, ingestion, and maintenance of external pricing files (e.g., NADAC, state MAC files, other benchmarks), including, performing data quality checks and validation, identifying and correcting anomalies or errors, conducting timely market research to support pricing accuracy and responsiveness, and resolve or escalate discrepancies, variance, or other anomaliesCreate and maintain a formal Tier 2 inquiry process for MAC-related issues, including tracking inquiry volume, documenting resolution and outcomes, assessing financial and operational impact, and supporting trend analysis and escalationCollaborate with other leaders to interpret and apply Medicaid regulations, state-specific requirements, and program initiatives to analytical models, pricing strategies, and reporting outputsCollaborate with internal stakeholders (e.g., Client Services, Contracting, Operations, Compliance) to evaluate the financial and contractual impact of Medicaid pricing and program decisionsInteract with external stakeholders and vendors, building collaborative relationships to support pricing accuracy, data transparency, and program executionSupport leadership with ad hoc analysis, forecasting, and scenario modeling related to Medicaid FFS pricing, program changes, and regulatory developmentsAssist leadership in supporting new Medicaid program initiatives, enhancements to pricing methodologies, and expansion of analytical capabilitiesContribute to the development of client- or state-facing materials and presentations, as needed, to explain pricing methodology, cost drivers, and program impactsPeriodic and detailed reporting of activities and opportunities to leadershipOther duties as assignedSkillsBachelor's degree in Finance, Economics, Healthcare Administration, Data Analytics, or related field, or equivalent work experience, required5+ years of experience in PBM, Medicaid pharmacy programs, managed care, healthcare analytics, or pricing analysis requiredExperience supporting Medicaid fee‑for‑service drug pricing methodologies in alignment with federal and state Medicaid requirements requiredExperience preparing documentation, reporting, and analysis to support internal reviews, regulatory inquiries, audits, and client requests requiredExperience working with industry pricing and reference sources, including Medi Span multisource and product codes (e.g., MONY indicators), NADAC pricing files, and HRSA 340B ceiling price data requiredExperience conducting pricing impact analyses and maintaining financial models to support Medicaid Statements of Work (SOWs), amendments, and renewals requiredParticipate in, adhere to, and support compliance program objectivesThe ability to consistently interact cooperatively and respectfully with other employeesBenefitsTop of the industry benefits for Health, Dental, and Vision insurance20 days paid time off4 weeks paid parental leave9 paid holidays401K company match of up to 5% - No vesting requirementAdoption Assistance ProgramFlexible Spending AccountEducational Assistance Plan and Professional Membership assistanceReferral Bonus Program – up to $750!Company OverviewNavitus Health Solutions LLC is a full service, URAC-accredited pharmacy benefit management company. It was founded in 2003, and is headquartered in Appleton, Wisconsin, USA, with a workforce of 1001-5000 employees. Its website is https://www.navitus.com/.