Sr. Analyst, Network Pricing Management, CVS Health

CVS Health

Location:
United States, Work At Home, Arizona

Category:
Finance

Contract Type:
Not provided

Salary:

46988.00 - 102000.00 USD / Year

Save Job

Apply Position

Job Description:

This position will be working with a team that is responsible for quality assurance reviews of our client and pharmacy pricing execution of network and mail pricing for CVS Health, a Fortune Company. The Sr. Analyst, you will ensure quality assurance for all client pricing implementations by auditing outputs from our teams across Employer, Health Plan, and Government segments. Your role covers all delivery systems and adjudication platforms related to pharmacy claims adjudication. You will inspect the correct application of business rules, implementation processes, network structures, and pricing documents.

Job Responsibility:

Ensure quality assurance for all client pricing implementations by auditing outputs from our teams across Employer, Health Plan, and Government segments
Inspect the correct application of business rules, implementation processes, network structures, and pricing documents
Operational support for the QA/QC process by reviewing upstream work outputs (e.g. Network Implementation forms), downstream post production (e.g. AS400 network profile coding validations), processing/running any number of tasks and jobs to support production (e.g. macros), and additional coding for state regulations

Requirements:

3-5 years of operational experience within PBM or Health Care industry
Ability to meet strict deadlines in a volume heavy environment
Intermediate to advanced proficiency in MS Office Suite of tools
Advanced proficiency in Excel and Access desired

Nice to have:

Quality assurance audit experience
Knowledge of CVS Caremark network programs and procedures, including knowledge of retail pharmacy operations and claims adjudication proficiency
Fundamental project management knowledge and/or demonstrable experience
Intermediate to advanced interpersonal skills as demonstrated by successful collaboration to achieve common and shared goals across business teams
Strong time management skills, evidenced by experience being accountable to multiple deliverables on staggered deadlines
Effective communication skills in both formal and informal written communications and speech at all levels of an organization
RxClaim system experience

What we offer:

Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan
No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching
Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility

Additional Information:

Job Posted:
August 04, 2025

Expiration:
August 22, 2025

Employment Type:

Fulltime

Work Type:

Remote work

View All Jobs In This Company

Job Link Share:

Sr. Analyst, Network Pricing Management