Pharmacy Network Analytics & Compliance Lead

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

Benefits offered by this job

Medical insurance

Dental coverage

Vision coverage

Paid time off

401(k) retirement

Job summary

CVS Health is seeking a Pharmacy Network Manager to support the Director of Network Pharmacy. This role focuses on data aggregation, analytics and reporting to enhance network performance and compliance.

Responsibilities include developing performance measures, managing stakeholder relationships, and addressing fraud, waste and abuse within the pharmacy network. This is a full-time role with a comprehensive benefits package and opportunities to impact network strategy.

Qualifications

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

Responsibilities

• Aggregate and analyze data to produce reports and respond to audits.
• Develop and implement performance measures for pharmacy network contracts.
• Identify and flag fraud, waste, and abuse within the network and recommend interventions.
• Collaborate with cross-functional teams to support strategic decisions.
• Manage relationships with internal stakeholders for alignment and communication.
• Monitor pharmacy performance and adherence to quality standards.

Skills

Data analysis

Reporting

Stakeholder management

Communication

Collaboration

Problem solving

Education

Bachelor's degree

Tools

Microsoft Excel

PivotTables

Power Query

VBA

Job description

CVS Health is seeking a Pharmacy Network Manager to support the Director of Network Pharmacy. This role focuses on data aggregation, analytics and reporting to enhance network performance and compliance.

Responsibilities include developing performance measures, managing stakeholder relationships, and addressing fraud, waste and abuse within the pharmacy network. This is a full-time role with a comprehensive benefits package and opportunities to impact network strategy.