Business Analytics Associate

7505 Caremark, L.L.C.; Arizona; Hybrid; USD 29,000 - 56,000; Full time

Benefits offered by this job

Medical benefits

Dental & Vision

Paid time off

Retirement savings

Wellness programs

Job summary

CVS Health in Arizona seeks a detail-oriented Non-MAC Reviewer to help manage pharmacy pricing appeals and regulatory inquiries. You will review Non-MAC pricing data, validate information from trusted sources, and partner with the Legal team to address state agency concerns.

The role requires PBM experience, familiarity with Non-MAC processes, and proficiency with data tools such as Excel and RxClaim (AS400).

Qualifications

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

Responsibilities

• Review and resolve pharmacy inquiries related to Non-MAC pricing
• Validate pricing and product information using trusted sources
• Monitor marketplace conditions and escalate issues promptly
• Assist contractors with questions and training support
• Back up lead tester for IT system testing and accuracy
• Research and respond to Department of Insurance (DOI) inquiries
• Support management with ad hoc tasks and projects

Skills

PBM experience

Non-MAC appeals knowledge

Education

Bachelor's Degree or equivalent

Tools

RxClaim (AS400)

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
• 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 andtimely 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

• 4 years 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)

Preferred Qualifications

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

Education

Bachelor's Degree or equivalent combination of work and experience

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.

Benefits

• 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.

Application Window Closing

We anticipate the application window for this opening will close on: 11/27/2026

Eligibility

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

Company Culture

Our Work Experience is the combination of everything that's unique about us: our culture, our core values, our company meetings, our commitment to sustainability, our recognition programs, but most importantly, it's our people. Our employees are self-disciplined, hard working, curious, trustworthy, humble, and truthful. They make choices according to what is best for the team, they live for opportunities to collaborate and make a difference, and they make us the #1 Top Workplace in the area.