Manager, Business Analytics - Pharmacy and Contract Compliance

At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.

As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.

Position Summary

The Manager, Pharmacy Analytics and Contract Compliance, will act as a subject matter expert on current contract terms and rate reconciliation data to deliver clear, actionable insights and reporting to our Payer Relations partners and external PBM clients. An individual in this position serves as an integral member of the Payer Reimbursement Analytics Team, reporting to the Senior Manager - Contract Compliance.

An individual in this role will be accountable for the management of a book of multiple PBM Payers on a monthly/quarterly cadence. Analysts will manage PBM impact in close coordination with the broader Payer Relations Financial Planning and Analysis team, as well as Payer Relations Directors.

As the Pharmacy Analytics and Contract Compliance Manager, you will play a key role in providing senior management with the information they need to make critical business decisions. Success in this role requires an individual to be accountable, adaptable, time-efficient, possess strong critical thinking and analytical skills, and effectively communicate at all levels of the organization.

This is a Hybrid role based in Woonsocket

The Pharmacy Analytics and Contract Compliance Manager is responsible for several financial, analytical, and reporting responsibilities including:

• Managing an assigned book of PBM payer data reconciliations at a monthly and/or quarterly cadence.
• Collaborating and sustaining business relationships with Payer Relations Directors and other Pharmacy Analytics and Contract Compliance Analysts on PBM compliance management.
• Coordinating and clearly communicating 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.
• Providing 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. 
• Ability to develop a deep understanding of PBM contract language, data requirements and reconciliation processes across multiple lines of business as well as serving as a SME and data steward for other Payer Relations Analysts, as well as Payer Relations 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, drawing conclusions from data, as well as problem-solving and troubleshooting.

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 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 businesses processes and identify key drivers of performance. 
• Detail-oriented and able to manage multiple projects simultaneously, prioritizing work, and communicating results in a manner that is clear, logical, consistent, and effective.
• 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

Time Type

Pay Range

The typical pay range for this role is:<