Associate Business Analytics

CVS Health is working to create a more connected, convenient, and compassionate health care experience. The Associate Business Analytics role supports MAC list maintenance, pricing uploads, quality control, reporting, pharmacy appeals, regulatory responses, and MAC adjustments related to client and pharmacy guarantees.

Responsibilities:

• The MAC team is responsible for all aspects of MAC list maintenance
• This includes creating new MAC lists and managing existing MAC lists, uploading MAC prices to the adjudication platform and all MAC related QC processes
• The MAC team works closely with the Finance Guarantee team to help ensure client commitments are met by making MAC adjustments as appropriate
• The MAC team is also responsible for reviewing and responding to all pharmacy MAC appeals and working with the Legal team to respond to any MAC related complaints from state agencies
• In addition, the MAC team monitors pharmacy GER guarantees and making MAC adjustments as needed
• The MAC team is also responsible for all MAC related reporting, including client and pharmacy reports

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 or equivalent work experience
• Experience with RxClaim platform (AS 400)
• Bachelor's Degree