Pharmacy Analytics & Compliance Associate

CVS Health; Phoenix (AZ); On-site; USD 29,000 - 56,000; Full time

Benefits offered by this job

Bonus program

Comprehensive benefits

Job summary

CVS Health in Phoenix seeks a dedicated professional to manage Non-MAC pricing appeals and regulatory inquiries. You will validate pricing data, coordinate with the Legal team, and assist with IT testing for system implementations.

The role requires 4 years of PBM experience, familiarity with RxClaim (AS400), and a Bachelor's degree. 40-hour weeks, full-time, with a strong benefits package and a CVS Health bonus program.

Qualifications

• 4 years PBM experience with non-MAC appeals, state regulations, and claims adjudication.
• Experience with RxClaim platform (AS400).
• Familiarity with pricing compliance and regulatory inquiries.

Responsibilities

• Review and respond to Non-MAC pricing inquiries and ensure regulatory compliance.
• Validate pricing and product info using Medispan and wholesaler data.
• Monitor market conditions and escalate issues to leadership.
• Support and train Non-MAC team contractors as needed.
• Assist IT testers with system implementation testing for accuracy.
• Research and respond to Department of Insurance inquiries.
• Provide ad hoc management support and special projects.

Skills

Excel

Word

Salesforce

Pharmacy Porta

Deadline-driven

Data analysis

RxClaim

Education

Bachelor's degree

Tools

RxClaim (AS400)

Job description

CVS Health in Phoenix seeks a dedicated professional to manage Non-MAC pricing appeals and regulatory inquiries. You will validate pricing data, coordinate with the Legal team, and assist with IT testing for system implementations.

The role requires 4 years of PBM experience, familiarity with RxClaim (AS400), and a Bachelor's degree. 40-hour weeks, full-time, with a strong benefits package and a CVS Health bonus program.