Pharmacy Network Analytics & Compliance Lead

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

Benefits offered by this job

Medical, dental, and vision coverage

Paid time off

Retirement savings options

Job summary

CVS Health is seeking a Pharmacy Network Manager to support the Director of Network Pharmacy in ensuring the efficient operation of the pharmacy network. This role involves data aggregation, analytics, and reporting responsibilities, with a focus on developing performance measures, managing relationships, and addressing fraud, waste, and abuse within the pharmacy network.

40 hours per week full-time, with collaboration across cross-functional teams and a strong emphasis on regulatory compliance

Qualifications

• Minimum 5 years in healthcare network management with statewide and multi-state experience.
• Minimum 3 years designing performance measurement frameworks and analytical reporting.
• 2-3 years applying pharmacy regulations, credentials, state filings, and audit prep.
• 2+ years of strong communication and stakeholder relationship skills.
• Ability to collaborate 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 fraud, waste, and abuse; recommend interventions.
• Collaborate with cross-functional teams to support strategic decisions.
• Manage relationships with internal stakeholders for alignment and communication.
• Support budget planning and financial performance analysis of the network.
• Contribute to quality improvement initiatives and ensure regulatory compliance.

Skills

Healthcare network management

Data analytics

Regulatory compliance

Communication

Stakeholder management

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 in ensuring the efficient operation of the pharmacy network. This role involves data aggregation, analytics, and reporting responsibilities, with a focus on developing performance measures, managing relationships, and addressing fraud, waste, and abuse within the pharmacy network.

40 hours per week full-time, with collaboration across cross-functional teams and a strong emphasis on regulatory compliance