Senior Pricing Analyst – Client Setup
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Job Description
Senior Pricing Analyst at CVS Health responsible for pricing strategies and operational support across multiple segments. Leading pricing setups and ensuring accuracy across claims adjudication platforms.
Responsibilities:
- Develop and execute network and mail pricing strategies for CVS Health
- Provide subject matter expertise and operational support for pricing implementations across Employer, Health Plan, and Government segments
- Lead the configuration and validation of pricing setups
- Ensure accuracy across pharmacy claims adjudication platforms
- Apply appropriate business rules, network structures, and pricing documentation
- Support ongoing and future pricing and product initiatives, including technology integration and testing
- Additional responsibilities include claims data analysis, process documentation, and audit preparation
Requirements:
- 3+ years of operational experience within PBM or Health Care industry
- 3+ years PBM or Health Care industry experience preferred
- Six Sigma belt certification preferred
- Intermediate knowledge of CVS Caremark network programs and procedures
- Knowledge of retail pharmacy operations and claims adjudication proficiency
- Fundamental project management knowledge and/or demonstrable experience preferred
- Operations experience in a volume heavy environment with strict deadlines
- Strong interpersonal skills
- Effective time management skills
- Intermediate proficiency in MS Office Suite of tools including Excel and Access desired
- Effective communication skills in both formal and informal written communications and speech at all levels of an organization
- Experience in compliance-driven environments such as Sarbanes-Oxley, SAS-70, and familiarity with Medicaid, Medicare, and state regulatory requirements preferred
Benefits:
- Affordable medical plan options
- 401(k) plan (including matching company contributions)
- Employee stock purchase plan
- No-cost programs for all colleagues including wellness screenings, tobacco cessation, and weight management programs
- Confidential counseling and financial coaching
- Paid time off
- Flexible work schedules
- Family leave
- Dependent care resources
- Colleague assistance programs
- Tuition assistance
- Retiree medical access
- Many other benefits depending on eligibility
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