Associate Business Analytics

CVSPharmacy

Work from home, IL

Full Time

Mid Level

21/hr-44/hr

2 days ago

Job Description

About the Role

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day. The MAC team is responsible for all aspects of MAC list maintenance, including creating and managing MAC lists, uploading MAC prices, and handling related QC processes. The team works closely with finance, legal, and pharmacy teams to ensure compliance, respond to appeals and complaints, monitor guarantees, and produce reports.

Key Responsibilities

Review and resolve pharmacy inquiries related to Maximum Allowable Cost (MAC) pricing, ensuring compliance with MAC law requirements.
Validate pricing and product information using trusted sources such as Medispan, manufacturers, and wholesalers.
Accurately update the Pharmacy Inquiry Database and ensure timely responses to pharmacies within established turnaround times (TAT).
Identify changes in marketplace conditions and promptly escalate potential issues to pharmacists to minimize impact on pharmacies and plan members.
Assist a team of coordinators by answering questions and providing training support as needed.
Monitor and perform testing activities related to IT system implementations to ensure functionality and accuracy.
Research and respond to Department of Insurance (DOI) inquiries, providing accurate and timely information to state regulators.
Provide assistance to management with various ad hoc tasks and special projects as assigned.

Requirements

2-5 years of experience in pharmacy benefit management (PBM), pharmaceutical pricing or reimbursement, healthcare compliance or regulatory affairs, data analysis or financial modeling.
Associate degree required.
Experience with RxClaim platform (AS 400) is preferred.
SAS experience is preferred.
Bachelor's Degree is preferred.

Nice to Have

Experience with RxClaim platform (AS 400).
SAS experience.
Bachelor's Degree.

Qualifications

Associate degree required.

Benefits & Perks

Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.

Working at CVSPharmacy

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

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