CVS Health
CVS Health
CVS Health — денсаулық сақтау қызметтері, медициналық сақтандыру, дәріхана жәрдемақыларын басқару және бөлшек дәріхана салаларында жұмыс істейтін америкалық денсаулық сақтау компаниясы. Aetna және CVS Caremark сияқты бизнес бағыттары арқылы медициналық сақтандыруды, рецепт бойынша дәрілерге қолжетімділікті, ауруларды басқаруды, арнайы дәрілерді және пошта арқылы дәріхана қызметтерін ұсынады. Оның жергілікті дәріханалары мен кең ауқымды медициналық қызметтері адамдарға негізгі медициналық көмекті ыңғайлырақ әрі қолжетімді бағамен алуға көмектесуге бағытталған. CVS Health сақтандыру, дәріхана және денсаулық сақтау қызметтерін біріктіріп, адамдар мен қауымдастықтарға емделу жолының барлық кезеңінде қолдау көрсетеді.

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.

Сипаттама

  • 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

Талаптар

  • 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

Артықшылықтар

  • 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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