Business Analytics Associate

CVS Health is dedicated to building a more connected and compassionate health experience. The Business Analytics Associate will support the MAC team by managing MAC lists, ensuring compliance, and responding to pharmacy inquiries related to pricing and regulations.

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)
• 2–5 years of experience in Pharmaceutical pricing or reimbursement
• 2–5 years of experience in Healthcare compliance or regulatory affairs
• 2–5 years of experience in Data analysis or financial modeling
• Education Associate degree required
• Experience with RxClaim platform (AS 400)
• SAS experience
• Bachelor's Degree