PBM Analytics & Compliance Associate

Arizona Small Business Association - ASBA; Arizona; On-site; USD 29,000 - 56,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

Paid time off

Job summary

CVS Health is seeking a detail-oriented Non-MAC analyst for the Non-MAC team to review and respond to pharmacy appeals, collaborating with Legal on related complaints. The role emphasizes pricing compliance, data validation, market monitoring, and regulatory inquiries while supporting management and IT testing activities.

The ideal candidate has 4 years PBM experience, a Bachelor's degree, and proficiency with RxClaim (AS400), Excel, Word, and Salesforce.

Qualifications

• 4 years PBM experience with non-MAC appeals, state regulations, and claims adjudication
• Experience with RxClaim platform (AS400)
• Bachelor's degree or equivalent combination of work and experience

Responsibilities

• Review and respond to Non-MAC pricing inquiries and resolutions
• Validate pricing and product information using trusted sources
• Monitor marketplace conditions and escalate issues to leadership
• Assist Non-MAC team contractors with questions and training
• Support IT system testing and validation activities

Skills

PBM experience

Data validation

Pricing compliance

RxClaim (AS400)

Education

Bachelor's degree

Tools

Excel

Word

Salesforce

Job description

CVS Health is seeking a detail-oriented Non-MAC analyst for the Non-MAC team to review and respond to pharmacy appeals, collaborating with Legal on related complaints. The role emphasizes pricing compliance, data validation, market monitoring, and regulatory inquiries while supporting management and IT testing activities.

The ideal candidate has 4 years PBM experience, a Bachelor's degree, and proficiency with RxClaim (AS400), Excel, Word, and Salesforce.