Pharmacy Data & Pricing 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

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