As a Network Product & Pricing Analyst you will be working with a team that is responsible for the development and execution of network and mail pricing for CVS Health, a Fortune 7 Company.
As a Analyst, your primary responsibility is being a subject matter expert for the Network Products and Pricing Team. The Implementation teams will manage product and pricing information across our Employer, Health Plan and Government business segments. You will have an opportunity to cross-functionally partner with both internal (Account Management, IT, Implementations, Benefits, CVS Health Senior Leaders, etc.) and external business partners (clients) for implementations and maintenance of business support.
An in depth understanding of claims adjudication including platform functionality, business rules and implementation processes is key to success in this role. Additionally, you should possess strong analytical skills to perform claims analysis and translate information to different levels of subject matter expertise (including Leadership).
In this role, strong interpersonal and communication skills are critical to resolve unique challenges that you may encounter in order to maintain client satisfaction. You will assist in supporting new and future product projects with a need for excellent attention to detail and to also provide product and new technologies testing support. You must be well organized, deadline focused and able to make decisions quickly and efficiently working in a team and autonomous environment as a self-starter and be comfortable working in different systems including AS400, SalesForce, and the Microsoft Suite (Excel, Access, outlook)
Three years work experience, preferably in PBM or Health Care industry experience, with knowledge of CVS Caremark network programs and procedures, including knowledge of retail pharmacy operations and claims adjudication.
COVID-19 Vaccination Requirement
CVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated.
You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.
• Fluent knowledge of Microsoft Office Suite of products including Outlook, Excel.
• PBM or Health Care industry experience
• RxClaim navigational skills
• Ability to run Queries, analyze and provide feedback, suggestions and/or recommendations
• Detailed claim research through data mining skills
• Must possess strong analytical skills and problem solving abilities, with excellent attention to detail.
• Ability to organize and manage multiple tasks and/or projects simultaneously.
• Outstanding written and oral communication skills.
Verifiable High School diploma or GED is required. Bachelor’s degree is preferred.
Bring your heart to CVS Health
Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as what we deliver.
Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.
We strive to promote and sustain a culture of diversity, inclusion and belonging every day.
CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.