Pharmacy Network Compliance Analyst

CVS Health Corporation

United States

Remote

USD 44,000 - 102,000

Full time

8 days ago

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Benefits offered by this job

Bonus program

Job summary

CVS Health Corporation is seeking an Analyst – Pharmacy Network Non-Compliance to investigate and resolve complex non-compliance issues within pharmacy contracts. The role requires coordination with cross-functional teams and meticulous attention to detail.

The position entails conducting outreach to network pharmacies, evaluating concerns, analyzing claims data, and preparing formal responses for sponsors and stakeholders. A bachelor’s degree and pharmacy-related experience are required.

Qualifications

Excellent oral and written communication skills.
Demonstrated analytical thinking and problem-solving ability.
Strong attention to detail and accuracy.

Responsibilities

Investigate and resolve pharmacy contract non-compliance allegations.
Conduct outreach to pharmacies to gather information and address issues.
Analyze claims data and adjudication results to support findings and recommendations.
Coordinate with Sales, Account Management, and other internal teams to drive resolution.
Prepare detailed written responses for plan sponsors, participants, and internal stakeholders.
Maintain documentation of investigations and outcomes.
Manage multiple cases with deadlines and accuracy.