CVS Health
CVS Health
CVS Health ir Amerikas Savienoto Valstu veselības aprūpes uzņēmums, kas darbojas veselības aprūpes pakalpojumu, veselības apdrošināšanas, aptieku pabalstu pārvaldības un mazumtirdzniecības aptieku jomā. Ar tādiem uzņēmumiem kā Aetna un CVS Caremark tas atbalsta veselības apdrošināšanas segumu, recepšu medikamentu pieejamību, veselības stāvokļa pārvaldību, specializētus medikamentus un medikamentu pasūtīšanu pa pastu. Uzņēmuma apkārtnes aptiekas un plašāki aprūpes pakalpojumi ir veidoti, lai cilvēki varētu ērtāk un izdevīgāk saņemt būtiski nepieciešamo veselības aprūpi. CVS Health apvieno apdrošināšanu, aptieku un veselības aprūpes pakalpojumus, lai atbalstītu cilvēkus un kopienas visā viņu aprūpes ceļā.

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.

Apraksts

  • 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

Prasības

  • 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

Priekšrocības

  • 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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