Associate Business Analytics
About The Position
We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. The MAC team is responsible for all aspects of MAC list maintenance. This includes creating new MAC lists and managing existing MAC lists, uploading MAC prices to the adjudication platform and all MAC related QC processes. The MAC team works closely with the Finance Guarantee team to help ensure client commitments are met by making MAC adjustments as appropriate. The MAC team is also responsible for reviewing and responding to all pharmacy MAC appeals and working with the Legal team to respond to any MAC related complaints from state agencies. In addition, the MAC team monitors pharmacy GER guarantees and making MAC adjustments as needed. The MAC team is also responsible for all MAC related reporting, including client and pharmacy reports.
Requirements
- 2–5 years of experience in: Pharmacy benefit management (PBM), Pharmaceutical pricing or reimbursement, Healthcare compliance or regulatory affairs, Data analysis or financial modeling
Nice To Haves
- Experience with RxClaim platform (AS 400)
Responsibilities
- Creating new MAC lists and managing existing MAC lists
- Uploading MAC prices to the adjudication platform
- Performing all MAC related QC processes
- Working closely with the Finance Guarantee team to help ensure client commitments are met by making MAC adjustments as appropriate
- Reviewing and responding to all pharmacy MAC appeals
- Working with the Legal team to respond to any MAC related complaints from state agencies
- Monitoring pharmacy GER guarantees and making MAC adjustments as needed
- Responsible for all MAC related reporting, including client and pharmacy reports
Benefits
- medical
- dental
- vision coverage
- paid time off
- retirement savings options
- wellness programs
- other resources, based on eligibility
- CVS Health bonus, commission or short-term incentive program
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
Associate degree
