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Job Details

CVS Health

Client Pricing Lead



Full Time

On Site


Scottsdale, Arizona, United States

Job Description
As the Client Pricing Lead, you will be working with a team that is responsible for the development and execution of network and mail pricing for CVS Health. In this critical, high impact position, you will lead and direct complex initiatives as a subject matter expert within Network Operations in areas of: client pricing, claims adjudication (including functionality on all adjudication platforms), business rules and implementation processes, testing and new initiative oversight across our Employer, Health Plan and Government business segments. You will have an integral role in Medicare Part D that continues to build on new and exciting pricing innovations in the marketplace with meaningful downstream impact. Some of your key responsibilities will include:
- Collaborating with both internal and external business partners for implementations and maintenance of business support
- Translating information from the business to key IT and benefits partners
- Acting as a subject matter expert on implementations with new clients
- Managing communications at all levels of the organization
- Influencing and negotiating change through relationship management

To be successful in this role you should be well organized, deadline focused and able to make decisions quickly and efficiently working in a team and autonomous environment. Your success will be determined by your ability to drive client satisfaction. Your analytical skills and ability to perform claims analysis and translate information to different levels of subject matter expertise (including Leadership) as well as pricing outputs by utilizing different query tools and resources will be tested. In this role, 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.

Pay Range
The typical pay range for this role is:
Minimum: 60,300
Maximum: 130,000

Please keep in mind that this range represents the pay range for all positions in the job grade within which this position falls. The actual salary offer will take into account a wide range of factors, including location.

Required Qualifications
* 5+ years PBM or Health Care industry experience

Preferred Qualifications
* Knowledge of CVS Caremark network programs and procedures, including knowledge of retail pharmacy operations and claims adjudication
* Proven MS Office Suite experience- primarily Excel, Access including Access database builds and/or Excel macro scripting
* Experience in large health plan pricing and adjudication
* Experience in Medicaid and/or Medicare program including pricing and regulatory environment participation
* Well developed project management skills
* Understanding of formal process improvement and/or six sigma methodologies
* Strong analytical skills and problem-solving ability
* 8+ years PBM or Health Care industry experience

* Verifiable High School diploma or GED is required
* Bachelors Degree is strongly preferred

Business Overview
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. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.