Pharmacy Network Analytics & Compliance Manager

Hispanic Alliance for Career Enhancement; Louisiana (MO); Hybrid; USD 54,300 - 159,120; Full time

Job summary

CVS Health is seeking a Pharmacy Network Manager to support the Director of Network Pharmacy, ensuring efficient operation of the pharmacy network through data aggregation, analytics and reporting. The role focuses on developing performance measures, managing relationships with stakeholders, and identifying fraud, waste and abuse while ensuring compliance with federal, state and local regulations.

This full-time position offers a comprehensive benefits package and opportunities to influence

Qualifications

• Minimum of 5 years in healthcare network management with multi-state experience.
• Minimum of 3 years designing performance measurement frameworks and analytics.
• 2–3 years applying pharmacy regulations, provider credentialing and state filings.
• Strong communication and stakeholder 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 pharmacy network.
• Collaborate with cross-functional teams to support strategic decision-making.
• Manage relationships with internal stakeholders for alignment and communication.
• Monitor pharmacy performance and ensure compliance with quality standards.
• Assist in budget planning and financial performance analysis.
• Contribute to quality improvement initiatives to enhance service delivery.
• Ensure compliance with federal, state, and local regulations.

Skills

Healthcare network management

Data analysis

Regulatory compliance

Communication & stakeholder management

Cross-functional collaboration

Education

Bachelor's Degree preferred

Tools

Excel

PivotTables

Power Query

VBA

Job description

CVS Health is seeking a Pharmacy Network Manager to support the Director of Network Pharmacy, ensuring efficient operation of the pharmacy network through data aggregation, analytics and reporting. The role focuses on developing performance measures, managing relationships with stakeholders, and identifying fraud, waste and abuse while ensuring compliance with federal, state and local regulations.

This full-time position offers a comprehensive benefits package and opportunities to influence