Pharmacy Network Analytics & Compliance Manager

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

Benefits offered by this job

Medical coverage

Dental coverage

Vision coverage

Paid time off

Retirement savings

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 individual contributor role focuses on data aggregation, analytics, and reporting.

You will develop performance measures, manage relationships with internal stakeholders, address fraud, waste, and abuse, and help monitor quality standards while supporting budgets and compliance.

Qualifications

• Minimum of 5 years of healthcare network management experience with demonstrated success in managing statewide and multi-state networks.
• Minimum of 3 years of experience designing performance measurement frameworks and generating analytical reports.
• 2-3 years of experience applying pharmacy regulations and compliance requirements.

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 pharmacy 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.
• Monitor pharmacy performance and ensure adherence to quality standards.
• Assist in budget planning and financial performance analysis of the pharmacy network.
• Contribute to quality improvement initiatives to enhance service delivery.
• Ensure compliance with federal, state, and local regulations.

Skills

Healthcare network management

Performance measurement frameworks

Regulatory compliance

Cross-functional collaboration

Stakeholder management

Excel proficiency

Power Query

PivotTables

VBA

Education

Bachelor's Degree preferred

Tools

Excel

Power Query

PivotTables

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 individual contributor role focuses on data aggregation, analytics, and reporting.

You will develop performance measures, manage relationships with internal stakeholders, address fraud, waste, and abuse, and help monitor quality standards while supporting budgets and compliance.