Pharmacy Network Analytics & Compliance Manager

Hispanic Alliance for Career Enhancement; Minnesota; 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 an experienced Pharmacy Network Manager to support the Director of Network Pharmacy in ensuring efficient operation of the network. The role focuses on data aggregation, analytics, reporting, and developing performance measures while addressing fraud, waste, and abuse within the network.

Responsibilities include auditing, contract performance, cross-functional collaboration, stakeholder communication, budget support, and regulatory compliance.

Qualifications

• Minimum of 5 years of healthcare network management experience with statewide and multi-state networks and regulatory filings.
• Minimum of 3 years designing performance measurement frameworks and producing analytical reports.
• 2-3 years applying pharmacy regulations and compliance requirements for network operations.
• Minimum 2 years of strong communication and stakeholder relationship skills.

Responsibilities

• Aggregate and analyze data to produce reports and respond to audits.
• Develop and implement performance measures for pharmacy network contracts.
• Identify fraud, waste, and abuse, 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 analysis of the network.
• Contribute to quality improvement initiatives in service delivery.
• Ensure compliance with federal, state, and local regulations.

Skills

Healthcare network management

Performance measurement

Regulatory compliance

Stakeholder communication

Cross-functional collaboration

Education

Bachelor's degree

Tools

Excel

Power Query

PivotTables

Job description

CVS Health is seeking an experienced Pharmacy Network Manager to support the Director of Network Pharmacy in ensuring efficient operation of the network. The role focuses on data aggregation, analytics, reporting, and developing performance measures while addressing fraud, waste, and abuse within the network.

Responsibilities include auditing, contract performance, cross-functional collaboration, stakeholder communication, budget support, and regulatory compliance.