Business Analytics Associate

CVS Health Careers

. Review and resolve pharmacy inquiries related to Non-MAC pricing while ensuring compliance with Non-MAC law requirements .

Posted 11/2/2026full-timeRemote • Arizona • United StatesMid-Level💰 $21 - $41 per hourWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in Pharmacy Benefit Management (PBM) with a strong focus on Non-MAC pricing compliance, claims adjudication, and regulatory inquiries. Proficient in utilizing various tools and platforms to validate pricing and support team operations effectively.

Highest-signal resume keywords

Pharmacy Benefit Management (PBM) ExperienceNon-MAC Appeal ProcessesRxClaim Platform (AS400)Excel ProficiencyClaims Adjudication Logic

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Non-MAC Pricing ComplianceClaims AdjudicationMathematical Problem-SolvingWholesaler Invoice FamiliarityIT System Testing

Soft Skills

Ability To Work Under Tight DeadlinesTraining And Support

Tools & Technologies

MedispanSalesforcePharmacy PortaExcelWord

Industry Keywords

Department Of Insurance InquiriesState RegulationsMarketplace MonitoringAd Hoc TasksSpecial Projects

About the role

Key responsibilities & impact

Review and resolve pharmacy inquiries related to Non-MAC pricing while ensuring compliance with Non-MAC law requirements
Validate pricing and product information using Medispan, wholesaler information, and other trusted sources
Monitor marketplace conditions and escalate potential issues to leadership
Support Non-MAC team contractors by answering questions and providing training
Monitor and perform testing activities for IT system implementations
Research and respond to Department of Insurance inquiries for submission to state regulators
Assist management with ad hoc tasks and special projects

Requirements

What you’ll need

4 years of Pharmacy Benefit Management (PBM) experience
Experience with all non-MAC appeal-related processes, state regulations, and claims adjudication, including claims adjudication logic
Experience with RxClaim platform (AS400)
Proficiency in Excel, Word, Salesforce, and Pharmacy Porta
Ability to work under tight deadlines
Strong mathematical problem-solving skills
Familiarity with wholesaler invoices
Bachelor's Degree or equivalent combination of work and experience

Benefits

Comp & perks

CVS Health bonus, commission or short-term incentive program
Medical coverage
Dental coverage
Vision coverage
Paid time off
Retirement savings options
Wellness programs
Other resources supporting physical, emotional, and financial well-being, based on eligibility