At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.Position Summary
As an Advisor of Pharmacy Network Analytics & Reporting, you will be responsible for researching, responding, tracking, and monitoring various regulatory inquiries, network provider complaints, and claim adjustment activity to ensure compliance with state and federal laws. The Advisor will be responsible for producing all required reporting to clients and regulatory agencies. Additional responsibilities include:
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- Assist the Network Account Management and Pharmacy Network Non-Compliance teams on a variety of outreach campaigns and claim research.
- Monitor and detect case trends that could have significant impact to clients, members, pharmacies and/or the PBM.
- Collaborate with a variety of business units to assist in the development of new processes and procedures as needed.
- 5+ years analytical experience in PBM or pharmacy industry
- Knowledge of health care/PBM/retail and long term care pharmacy industries
- Assertive, self-starter; able to make decisions independently
- Ability to facilitate and translate difficult, complex and sensitive situations
- Demonstrated organizational/follow-up skills
- Must be able to work efficiently. Must be able to handle and manage numerous projects, requests and deadlines
- Knowledge of claims adjudication and the economics of the pharmacy business.
- Solid math skills and ability to understand financial terms and work with complex and sensitive financial data
- Ability to follow Policy and Procedure regarding handling of Protected Health Information
- Computer skills including MS Word, Access and Excel
- Bachelors degree or equivalent work experience required
40Time Type
Full timePay Range
The typical pay range for this role is:$54,300.00 - $159,120.00This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.Great benefits for great peopleWe take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:
- Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
- No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
- Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.