Business Analytics Associate

CVS Health • Work At Home-Arizona, AZ

3d • $21 - $41

About The Position

The Business Analytics Associate supports CVS Health’s Non-MAC team, which reviews and responds to pharmacy Non-MAC appeals and collaborates with the Legal team on Non-MAC-related complaints from state agencies. The role reviews and resolves pharmacy inquiries about Non-MAC pricing, validates pricing and product information, monitors marketplace conditions, and supports regulatory inquiries and IT implementation testing. It also assists contractors with questions and training and provides management with ad hoc support and special-project assistance.

Requirements

• Four years of Pharmacy Benefit Management (PBM) experience involving Non-MAC appeal processes, state regulations, and claims adjudication, including claims adjudication logic.
• Experience with the RxClaim platform (AS400).
• Bachelor’s degree or an equivalent combination of work and experience.

Nice To Haves

• Proficiency in Excel, Word, Salesforce, and Pharmacy Porta.
• Ability to work under tight deadlines.
• Strong mathematical problem-solving skills.
• Familiarity with wholesaler invoices.

Responsibilities

• Review and resolve pharmacy inquiries related to Non-MAC pricing while ensuring compliance with Non-MAC law requirements.
• Validate pricing and product information using sources such as Medispan and wholesaler information.
• Monitor marketplace changes and escalate potential issues to leadership to minimize effects on pharmacies and plan members.
• Answer questions from Non-MAC team contractors and provide training support as needed.
• Back up the lead tester by monitoring and performing testing activities for IT system implementations as needed.
• Research and respond to Department of Insurance inquiries, providing accurate and timely information to the DOI team for submission to state regulators.
• Assist management with ad hoc tasks and special projects as assigned.

Benefits

• Medical coverage
• Dental coverage
• Vision coverage
• Paid time off
• Retirement savings options
• Wellness programs
• Other resources, based on eligibility
• Eligible for a CVS Health bonus, commission, or short-term incentive program in addition to base pay

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level