Note: The job is a remote job and is open to candidates in USA. 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
Skills
- 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
Benefits
- This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.
- This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families.
- The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.
Company Overview
CVS Health is a health solutions company that provides an integrated healthcare services to its members. It was founded in 1963, and is headquartered in Woonsocket, Rhode Island, USA, with a workforce of 10001+ employees. Its website is https://www.cvshealth.com/.