Pharmacy Network Analytics and Compliance Lead

Hispanic Alliance for Career Enhancement; Illinois; Hybrid; USD 54,300 - 159,120; Full time

Benefits offered by this job

Healthcare benefits

Performance bonuses

Job summary

CVS Health is seeking a Pharmacy Network Manager to support the Director of Network Pharmacy in ensuring efficient operation of the pharmacy network. This role focuses on data aggregation, analytics and reporting, with emphasis on performance measures, stakeholder management, and compliance with regulations.

The position requires healthcare network management experience, strong analytics, and the ability to collaborate across departments to optimize network performance and ensure quality

Qualifications

• Minimum of 5 years of healthcare network management experience with statewide and multi-state networks.
• Minimum of 3 years designing performance measurement frameworks and generating analytical reports.
• 2-3 years applying pharmacy regulations and compliance requirements for network operations.
• Minimum of 2 years of strong communication and relationship management skills.
• Ability to work collaboratively with cross-functional teams.

Responsibilities

• Aggregate and analyze data to produce detailed reports and respond to audits.
• Develop and implement performance measures for pharmacy network contracts.
• Identify and flag potential fraud, waste, and abuse within the network and recommend interventions.
• Collaborate with cross-functional teams to support strategic decision-making.
• Manage relationships with internal stakeholders to ensure alignment and effective communication.
• Support monitoring of pharmacy performance and adherence to quality standards.
• Assist in budget planning and financial performance analysis of the network.
• Contribute to quality improvement initiatives to enhance service delivery.
• Ensure compliance with federal, state, and local regulations.

Skills

Data analysis

Stakeholder management

Regulatory compliance

Cross-functional collaboration

Communication

Education

Bachelor's degree

Tools

Excel

PivotTables

Power Query

VBA

Job description

CVS Health is seeking a Pharmacy Network Manager to support the Director of Network Pharmacy in ensuring efficient operation of the pharmacy network. This role focuses on data aggregation, analytics and reporting, with emphasis on performance measures, stakeholder management, and compliance with regulations.

The position requires healthcare network management experience, strong analytics, and the ability to collaborate across departments to optimize network performance and ensure quality