CVS Health
CVS Health
CVS Health sog‘liqni saqlash xizmatlari, tibbiy sug‘urta, dorixona imtiyozlarini boshqarish va chakana dorixona faoliyati yo‘nalishlarida ishlaydigan Amerika kompaniyasidir. Aetna va CVS Caremark kabi bizneslari orqali tibbiy sug‘urta qamrovi, retsept bo‘yicha dori vositalaridan foydalanish, kasalliklarni boshqarish, maxsus dori-darmonlar va pochta orqali dorixona xizmatlarini taqdim etadi. Uning mahalliy dorixonalari va keng qamrovli tibbiy xizmatlari odamlarga zarur tibbiy yordamdan qulayroq va hamyonboproq foydalanishga yordam berish uchun mo‘ljallangan. CVS Health sug‘urta, dorixona va sog‘liqni saqlash xizmatlarini birlashtirib, insonlar va jamoalarni davolanish jarayonining barcha bosqichlarida qo‘llab-quvvatlaydi.

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.

Tavsif

  • 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

Talablar

  • 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

Imtiyozlar

  • 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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