Pharmacy Network Analytics & Compliance Lead

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

Benefits offered by this job

Bonus opportunity

Comprehensive benefits

Job summary

CVS Health is seeking a Pharmacy Network Manager to support the Director of Network Pharmacy, focusing on data aggregation, analytics, and reporting to improve the efficiency and compliance of the network. The role will involve developing performance measures, managing relationships, and addressing fraud, waste, and abuse within the pharmacy network.

Ideal candidates have extensive healthcare network management experience, strong regulatory knowledge, and proven track records in cross-functional

Qualifications

• 5+ years in healthcare network management with multi-state experience.
• 3+ years designing performance measurement frameworks and reporting.
• 2-3 years applying pharmacy regulations and compliance.
• 2+ years of stakeholder relationship management and cross-functional collaboration.

Responsibilities

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

Skills

Stakeholder management

Cross-functional collaboration

Data-driven decision making

Regulatory knowledge

Education

Bachelor's Degree preferred

Tools

Microsoft Excel

PivotTables

Power Query

Excel VBA/macros

Job description

CVS Health is seeking a Pharmacy Network Manager to support the Director of Network Pharmacy, focusing on data aggregation, analytics, and reporting to improve the efficiency and compliance of the network. The role will involve developing performance measures, managing relationships, and addressing fraud, waste, and abuse within the pharmacy network.

Ideal candidates have extensive healthcare network management experience, strong regulatory knowledge, and proven track records in cross-functional