Healthcare Analytics Associate: PBM & Non-MAC
7505 Caremark, L.L.C.
An application made for this job — a tailored resume and cover letter that speak straight to the posting.
Benefits offered by this job
Job summary
CVS Health in Arizona is seeking a responsible professional to join the Non‑MAC team. The role focuses on reviewing Non‑MAC pricing appeals, validating data from sources like Medispan, and assisting with regulatory inquiries to state agencies. The candidate will collaborate with Legal and have opportunities to contribute to process improvements.
The position requires a Bachelor's degree and PBM experience. Proficiency with Excel, Salesforce, and Pharmacy Portal is preferred.
Qualifications
- 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.
Responsibilities
- Review and resolve Non‑MAC pricing inquiries to ensure compliance.
- Validate pricing and product information using trusted sources.
- Monitor marketplace conditions and escalate issues to leadership.
- Assist team contractors by answering questions and providing training support.
- Backup lead tester for IT system implementations to ensure functionality.
- Respond to Department of Insurance (DOI) inquiries with accurate information.
- Support management with ad hoc tasks and special projects.
Skills
Education
Tools
Job description
CVS Health in Arizona is seeking a responsible professional to join the Non‑MAC team. The role focuses on reviewing Non‑MAC pricing appeals, validating data from sources like Medispan, and assisting with regulatory inquiries to state agencies. The candidate will collaborate with Legal and have opportunities to contribute to process improvements.
The position requires a Bachelor's degree and PBM experience. Proficiency with Excel, Salesforce, and Pharmacy Portal is preferred.
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