CVS Health
Manager, Business Analytics - Pharmacy and Contract Compliance
CVS Health, Woonsocket, Rhode Island, us, 02895
Manager, Business Analytics - Pharmacy and Contract Compliance
Join CVS Health as a Manager, Business Analytics – focused on Pharmacy and Contract Compliance. You will be a subject‑matter expert on contract terms, rate reconciliation data, and deliver clear, actionable insights to Payer Relations partners and external PBM clients.
Position Summary As a key member of the Payer Reimbursement Analytics Team, you will manage a book of PBM payers on a monthly/quarterly cadence, collaborate with Payer Relations Directors, and provide senior leadership with insights that drive critical business decisions. The role is hybrid and requires on‑site attendance at our Woonsocket, RI office.
Responsibilities
Manage an assigned book of PBM payer data reconciliations on a monthly and/or quarterly cadence.
Collaborate and sustain business relationships with Payer Relations Directors and other Pharmacy Analytics and Contract Compliance Analysts on PBM compliance management.
Coordinate and communicate impact between adjudication and overall pricing guarantees to senior leadership and Payer Relations Directors.
Partner with Payer Relations Directors to negotiate contract settlements with data‑driven insights.
Provide insights to senior leadership on process improvements, leveraging new technology and improved data sets to refine existing reporting and reconciliation processes.
The Ideal Candidate Will Have
Combination of business and technical/analytical expertise to generate customized, actionable insights in a data‑driven and deadline‑oriented environment.
Strong analytical and quantitative skills; outstanding strategic thinking and problem‑solving skills.
Deep understanding of PBM contract language, data requirements and reconciliation processes across multiple lines of business, serving as SME and data steward for other Payer Relations Analysts and Directors.
Ability to identify complex problems and develop actionable solutions through data analysis and observation.
Experience building financial modeling, measuring financial impact, identifying trends and anomalies, and drawing conclusions from data.
Required Qualifications
3+ years of professional work experience.
3+ years of data analytics work using Excel/Access, other business intelligence or reporting tools.
Preferred Qualifications
Experience with SQL, Salesforce, Foundry, Tableau, Power BI strongly preferred.
1+ years of financial modeling experience is a significant plus.
1+ years of Pharmacy work experience.
Ability to learn new tools and skills quickly is strongly preferred.
Excellent written and oral communication and strong presentation skills.
Ability to quickly learn new business processes and identify key drivers of performance.
Detail‑oriented and able to manage multiple projects simultaneously, prioritizing work, and communicating results in a clear, logical, consistent, and effective manner.
Results‑driven with a desire to work in a dynamic environment that values collaboration, integrity, and accountability.
Education Bachelor’s Degree or 4+ years of industry‑related analytical experience.
Anticipated Weekly Hours 40
Time Type Full time
Pay Range $66,330.00 – $145,860.00 (base annual salary).
Great Benefits For Great People
Affordable medical plan options, a 401(k) plan (including company matching), and an employee stock purchase plan.
No‑cost programs for all colleagues including wellness screenings, tobacco cessation, 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.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
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Position Summary As a key member of the Payer Reimbursement Analytics Team, you will manage a book of PBM payers on a monthly/quarterly cadence, collaborate with Payer Relations Directors, and provide senior leadership with insights that drive critical business decisions. The role is hybrid and requires on‑site attendance at our Woonsocket, RI office.
Responsibilities
Manage an assigned book of PBM payer data reconciliations on a monthly and/or quarterly cadence.
Collaborate and sustain business relationships with Payer Relations Directors and other Pharmacy Analytics and Contract Compliance Analysts on PBM compliance management.
Coordinate and communicate impact between adjudication and overall pricing guarantees to senior leadership and Payer Relations Directors.
Partner with Payer Relations Directors to negotiate contract settlements with data‑driven insights.
Provide insights to senior leadership on process improvements, leveraging new technology and improved data sets to refine existing reporting and reconciliation processes.
The Ideal Candidate Will Have
Combination of business and technical/analytical expertise to generate customized, actionable insights in a data‑driven and deadline‑oriented environment.
Strong analytical and quantitative skills; outstanding strategic thinking and problem‑solving skills.
Deep understanding of PBM contract language, data requirements and reconciliation processes across multiple lines of business, serving as SME and data steward for other Payer Relations Analysts and Directors.
Ability to identify complex problems and develop actionable solutions through data analysis and observation.
Experience building financial modeling, measuring financial impact, identifying trends and anomalies, and drawing conclusions from data.
Required Qualifications
3+ years of professional work experience.
3+ years of data analytics work using Excel/Access, other business intelligence or reporting tools.
Preferred Qualifications
Experience with SQL, Salesforce, Foundry, Tableau, Power BI strongly preferred.
1+ years of financial modeling experience is a significant plus.
1+ years of Pharmacy work experience.
Ability to learn new tools and skills quickly is strongly preferred.
Excellent written and oral communication and strong presentation skills.
Ability to quickly learn new business processes and identify key drivers of performance.
Detail‑oriented and able to manage multiple projects simultaneously, prioritizing work, and communicating results in a clear, logical, consistent, and effective manner.
Results‑driven with a desire to work in a dynamic environment that values collaboration, integrity, and accountability.
Education Bachelor’s Degree or 4+ years of industry‑related analytical experience.
Anticipated Weekly Hours 40
Time Type Full time
Pay Range $66,330.00 – $145,860.00 (base annual salary).
Great Benefits For Great People
Affordable medical plan options, a 401(k) plan (including company matching), and an employee stock purchase plan.
No‑cost programs for all colleagues including wellness screenings, tobacco cessation, 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.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
#J-18808-Ljbffr