Business Analytics Associate

CVSHealth; Arizona; On-site; USD 29,000 - 56,000; Full time

Job summary

CVS Health is seeking a full‑time Non‑MAC Appeals Analyst to review and respond to Non‑MAC pricing inquiries, validate data, and monitor market conditions. The role collaborates with the Legal team to address state regulator inquiries and supports IT testing for system implementations.

40 hours per week, based in Arizona, with eligibility for CVS Health bonus programs. The ideal candidate has PBM experience with non‑MAC processes, familiarity with RxClaim (AS400), and strong

Qualifications

• PBM experience with non-MAC appeals, state regulations, and claims adjudication.
• Experience with RxClaim platform (AS400).
• Bachelor's degree required.
• Proficiency in Excel and Salesforce preferred, plus familiarity with Pharmacy Portal.

Responsibilities

• Review and resolve Non-MAC pricing inquiries in compliance with applicable law.
• Validate pricing and product information using trusted sources.
• Monitor market conditions and escalate issues to leadership.
• Support and train Non-MAC team contractors as needed.
• Back up testing for IT system implementations and ensure functionality.
• Research and respond to Department of Insurance inquiries for regulators.
• Provide ad hoc support to management.

Skills

PBM experience with non-MAC appeals

Ability to work under tight deadlines

Mathematical problem-solving

Education

Bachelor's Degree

Tools

RxClaim (AS400)

Excel

Salesforce

Pharmacy Portal

Job description

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.

Position Summary

The Non-MAC team is responsible for reviewing and responding to all pharmacy Non-MAC pharmacy appeals and collaborating with the Legal team to respond to any Non-MAC related complaints from state agencies.

Responsibilities

• Non-MAC Pricing Compliance & Inquiry Resolution
  Review and resolve pharmacy inquiries related to Non-MAC pricing, ensuring compliance with Non-MAC law requirements.
• Data Validation & Source Verification
  Validate pricing and product information using trusted sources such as Medispan and wholesaler information.
• Market Monitoring & Issue Escalation
  Identify changes in marketplace conditions and promptly elevate potential issues to leadership to minimize impact on pharmacies and plan members.
• Team Support & Training
  Assist the Non-MAC team contractors by answering questions and providing training support as needed.
• IT Implementation Testing
  Back up lead tester by monitoring and performing testing activities related to IT system implementations to ensure functionality and accuracy as needed.
• Regulatory Inquiry Support
  Research and respond to Department of Insurance (DOI) inquiries, providing accurate and timely information to the DOI team to submit to state regulators.
• Ad Hoc Management Support
  Provide assistance to management with various ad hoc tasks and special projects as assigned.

Required Qualifications

• Pharmacy Benefit Management (PBM) experience with all non-MAC appeal related processes, state regulations, and claims adjudication, including claims adjudication logic
• Experience with RxClaim platform (AS400)

Education

Bachelor's Degree required

Preferred Qualifications

• Proficient in Excel, Word, Salesforce, and Pharmacy Portal
• Ability to work under tight deadlines
• Strong mathematical problem-solving skills
• Familiarity with wholesaler invoices

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is:

$21.10 - $40.90

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.

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.

Great benefits for great people

We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.

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.

Additional details about available benefits are provided during the application process and on Benefits Moments.

We anticipate the application window for this opening will close on: 10/09/2026

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.