Associate Business Analyst
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Job Description
Associate Business Analytics managing MAC lists, pricing, appeals, and compliance reporting. Supporting CVS Health’s mission to simplify healthcare through accurate pharmacy benefit administration.
Responsibilities:
- Create new MAC lists and manage existing MAC lists
- Upload MAC prices to the adjudication platform
- Perform MAC-related quality control processes
- Collaborate with the Finance Guarantee team to help ensure client commitments are met
- Make MAC adjustments as appropriate and as needed
- Review and respond to pharmacy MAC appeals
- Work with the Legal team to respond to MAC-related complaints from state agencies
- Monitor pharmacy GER guarantees
- Prepare MAC-related reporting, including client and pharmacy reports
Requirements:
- 2–5 years of experience in pharmacy benefit management (PBM), pharmaceutical pricing or reimbursement, healthcare compliance or regulatory affairs, data analysis or financial modeling
- Experience with RxClaim platform (AS 400) preferred
- Associate Degree or equivalent work experience
- Bachelor's Degree preferred
Benefits:
- Medical coverage
- Dental coverage
- Vision coverage
- Paid time off
- Retirement savings options
- Wellness programs
- Other resources supporting physical, emotional, and financial well-being
- CVS Health bonus, commission or short-term incentive program
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