Pharmacy Network Analytics & Compliance Manager

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

Job summary

CVS Health is looking for a Pharmacy Network Manager to support the Director of Network Pharmacy by aggregating data, creating reports, and developing performance measures for the pharmacy network.

You will identify fraud, waste, and abuse, coordinate with cross-functional teams, manage stakeholder relationships, and ensure compliance with federal, state, and local regulations while contributing to budget and quality improvement initiatives.

Qualifications

• Minimum of 5 years of healthcare network management experience with statewide and multi-state oversight.
• Minimum of 3 years designing performance measures and generating analytical reports.
• 2-3 years applying pharmacy regulations, including state filings and audit prep.
• 2+ years of strong communication and stakeholder relationship management.

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 network and recommend interventions.
• Collaborate with cross-functional teams to support strategic decision-making.
• Manage relationships with internal stakeholders for alignment and communication.
• Support monitoring of pharmacy performance and adherence to quality standards.
• Assist in budget planning and financial performance analysis of the network.
• Contribute to quality improvement initiatives to enhance service delivery.
• Ensure compliance with federal, state, and local regulations.

Skills

Healthcare network management

Regulatory compliance

Data analytics

Cross-functional collaboration

Stakeholder communication

Education

Bachelor's Degree preferred

Tools

Microsoft Excel

PivotTables

Power Query

Excel VBA

Job description

CVS Health is looking for a Pharmacy Network Manager to support the Director of Network Pharmacy by aggregating data, creating reports, and developing performance measures for the pharmacy network.

You will identify fraud, waste, and abuse, coordinate with cross-functional teams, manage stakeholder relationships, and ensure compliance with federal, state, and local regulations while contributing to budget and quality improvement initiatives.