Summary
CVS Health is working to create a more connected, convenient, and compassionate health care experience. The Associate Business Analytics role supports MAC list maintenance, pricing uploads, quality control, reporting, pharmacy appeals, regulatory responses, and MAC adjustments related to client and pharmacy guarantees.
Responsibilities
- 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
Skills
- 2–5 years of experience in: Pharmacy benefit management (PBM), Pharmaceutical pricing or reimbursement, Healthcare compliance or regulatory affairs, Data analysis or financial modeling
- Associate Degree or equivalent work experience
- Experience with RxClaim platform (AS 400)
- Bachelor's Degree
Qualifications
Must Haves
- 2–5 years of experience in: Pharmacy benefit management (PBM), Pharmaceutical pricing or reimbursement, Healthcare compliance or regulatory affairs, Data analysis or financial modeling
- Associate Degree or equivalent work experience
Nice to Haves
- Experience with RxClaim platform (AS 400)
- Bachelor's Degree
Benefits
- This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families.
- Medical, dental, and 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 the base pay range listed above