Manager, Business Analytics - Pharmacy and Contract Compliance at CVS Health

Woonsocket, Rhode Island, United States

Apply Now

Not SpecifiedCompensation

Mid-level (3 to 4 years), Senior (5 to 8 years)Experience Level

Full TimeJob Type

UnknownVisa

Healthcare, PharmacyIndustries

Requirements

3+ years of professional work experience
3+ years of data analytics work using Excel/Access, other business intelligence or reporting tools
Strong analytical and quantitative skills
Outstanding strategic thinking and problem-solving skills
Ability to develop a deep understanding of PBM contract language, data requirements and reconciliation processes across multiple lines of business
Ability to identify complex problems and develop actionable solutions through data analysis and observation
Experience building financial modeling, measuring financial impact, identifying trends and anomalies, drawing conclusions from data, as well as problem-solving and troubleshooting
Combination of business and technical/analytical expertise to generate customized, actionable insights in a data-driven and deadline-oriented environment
Ability to be accountable, adaptable, time-efficient, possess strong critical thinking and analytical skills, and effectively communicate at all levels of the organization
Excellent written and oral communication and strong presentation skills
Ability to learn new tools and skills quickly (preferred)
Experience with SQL, Salesforce, Foundry, Tableau, Power BI (preferred)
1+ years financial modeling experience (preferred)
1+ years of Pharmacy work experience (preferred)
Ability to commute to Woonsocket, RI office for hybrid work

Responsibilities

Managing an assigned book of PBM payer data reconciliations at a monthly and/or quarterly cadence
Collaborating and sustaining business relationships with Payer Relations Directors and other Pharmacy Analytics and Contract Compliance Analysts on PBM compliance management
Coordinating and clearly communicating impact between adjudication and overall pricing guarantees to senior leadership and Payer Relations Directors
Partnering with Payer Relations Directors to negotiate contract settlements with data-driven insights
Providing insights to senior management on process improvements, leveraging new technology and improved data sets to refine existing reporting and reconciliation processes
Acting as a subject matter expert on current contract terms and rate reconciliation data to deliver clear, actionable insights and reporting to Payer Relations partners and external PBM clients
Serving as an integral member of the Payer Reimbursement Analytics Team, reporting to the Senior Manager - Contract Compliance
Managing PBM impact in close coordination with the broader Payer Relations Financial Planning and Analysis team, as well as Payer Relations Directors
Providing senior management with the information they need to make critical business decisions
Serving as a SME and data steward for other Payer Relations Analysts, as well as Payer Relations Directors

Skills

analytics

data reconciliation

contract compliance

financial analysis

reporting

SQL

Excel

PBM

payer relations

rate reconciliation

CVS Health

Comprehensive pharmacy and healthcare services

About CVS Health

CVS Health operates a large network of retail pharmacies and walk-in medical clinics across the United States, providing a variety of health-related products and services. Their offerings include prescription medications, over-the-counter health products, and beauty items, as well as pharmacy benefits management and specialty pharmacy services. CVS Health's integrated business model allows them to serve individual consumers, businesses, and communities effectively, with a focus on improving health outcomes and reducing healthcare costs. Unlike many competitors, CVS Health combines pharmacy services with medical care, making it easier for patients to access quality healthcare. The company's goal is to enhance access to healthcare and support individuals in achieving better health.

Woonsocket, Rhode IslandHeadquarters

1963Year Founded

DEBTCompany Stage

Healthcare, Consumer GoodsIndustries

10,001+Employees

Benefits

Health Insurance

Dental Insurance

Vision Insurance

Life Insurance

Disability Insurance

401(k) Retirement Plan

Company Equity

Wellness Program

Professional Development Budget

Paid Vacation

Paid Holidays

Risks

Legal challenges related to opioid prescriptions could harm CVS's reputation and finances.

The DOJ's intervention in a whistleblower lawsuit may increase legal costs for CVS.

The Horizon Organic Milk recall exposes potential vulnerabilities in CVS's supply chain.

Differentiation

CVS Health operates over 9,600 retail pharmacies and 1,100 walk-in clinics nationwide.

The company integrates pharmacy benefits management with specialty pharmacy services for comprehensive care.

CVS Health offers tailored medication plans through personalized medicine and pharmacogenomics.

Upsides

Expansion of telehealth services allows CVS to reach more patients remotely.

Increased consumer interest in wellness boosts demand for CVS's health-related products.

The trend towards value-based care aligns with CVS's integrated healthcare approach.

Land your dream remote job 3x faster with AI

Try Jobo Free