Pharmacy Network Performance Manager

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

Benefits offered by this job

Comprehensive benefits package

Bonus eligibility

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 involves data aggregation, analytics, and reporting responsibilities, with a focus on developing performance measures, managing relationships, and addressing fraud, waste, and abuse within the pharmacy network.

The position focuses on identifying fraud, waste, and abuse, collaborating with cross‑functional

Qualifications

• Minimum of 5 years of healthcare network management experience, with statewide and multi‑state networks.
• Minimum of 3 years designing performance measurement frameworks and generating analytical reports.
• 2-3 years applying pharmacy regulations and compliance requirements, including network adequacy standards and audits.
• Minimum of 2 years demonstrating strong communication and relationship management skills.
• Ability to work collaboratively with cross‑functional teams.

Responsibilities

• Aggregate and analyze data to produce reports and respond to audits.
• Develop and implement performance measures for pharmacy network contracts.
• Identify and flag potential fraud, waste, and abuse and intervene.
• Collaborate with cross‑functional teams to support strategic decision‑making.
• Manage relationships with internal stakeholders to ensure alignment and effective communication.
• Support the Director of Network Pharmacy in monitoring performance and quality standards.
• Assist in budget planning and financial performance analysis for the network.
• Contribute to quality improvement initiatives to enhance service delivery.
• Ensure compliance with federal, state, and local regulations.

Skills

Network management

Data analytics

Regulatory compliance

Stakeholder management

Cross-functional collaboration

Education

Bachelor's degree

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 involves data aggregation, analytics, and reporting responsibilities, with a focus on developing performance measures, managing relationships, and addressing fraud, waste, and abuse within the pharmacy network.

The position focuses on identifying fraud, waste, and abuse, collaborating with cross‑functional