CVS Health
CVS Health
CVS Health एक अमेरिकी स्वास्थ्य सेवा कंपनी है, जो स्वास्थ्य सेवाओं, स्वास्थ्य बीमा, फार्मेसी लाभ प्रबंधन और रिटेल फार्मेसी के क्षेत्रों में काम करती है। Aetna और CVS Caremark जैसे व्यवसायों के माध्यम से यह स्वास्थ्य कवरेज, दवाओं तक पहुंच, रोग प्रबंधन, विशेष दवाओं और मेल-ऑर्डर फार्मेसी सेवाओं में सहायता प्रदान करती है। इसकी स्थानीय फार्मेसियां और व्यापक स्वास्थ्य सेवाएं लोगों को आवश्यक स्वास्थ्य देखभाल अधिक सुविधाजनक और किफायती तरीके से प्राप्त करने में मदद करने के लिए बनाई गई हैं। CVS Health बीमा, फार्मेसी और स्वास्थ्य सेवाओं को एक साथ लाकर लोगों और समुदायों को उनकी स्वास्थ्य यात्रा के दौरान सहयोग प्रदान करती है।

Associate Business Analyst, Pharmacy Benefits - CVS Health Remote

Support pharmacy benefit operations at CVS Health by managing MAC pricing, appeals, guarantees, and compliance reporting. This role helps maintain accurate adjudication and meet client and regulatory commitments.

विवरण

  • Develop and maintain MAC lists
  • Upload MAC pricing to the adjudication platform
  • Complete quality-control checks for MAC data and processes
  • Partner with the Finance Guarantee team to support client commitments
  • Apply MAC adjustments when appropriate
  • Review and resolve pharmacy MAC appeals
  • Coordinate with Legal on MAC-related complaints from state agencies
  • Track pharmacy GER guarantees
  • Produce MAC reports for clients and pharmacies

आवश्यकताएँ

  • Two to five years of experience in PBM, pharmaceutical pricing or reimbursement, healthcare compliance or regulatory affairs, data analysis, or financial modeling
  • Experience with the RxClaim platform and AS400 is preferred
  • Associate degree or equivalent professional experience
  • Bachelor's degree is preferred

लाभ

  • Medical coverage
  • Dental coverage
  • Vision coverage
  • Paid time off
  • Retirement savings options
  • Wellness programs
  • Resources supporting physical, emotional, and financial well-being
  • CVS Health bonus, commission, or short-term incentive program

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