Manager, Business Analytics - Pharmacy and Contract Compliance

Manager, Pharmacy Analytics 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. 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 position is hybrid at our Woonsocket, RI office. Candidates must be able to commute to this location.

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 :

Required Qualifications :

Preferred Qualifications :

Education : Bachelor's Degree or 4+ years of industry-related analytical experience.

Anticipated Weekly Hours : 40

Time Type : Full time

Pay Range : The typical pay range for this role is : $66,330.00 - $145,860.00

Great benefits for great people

We take pride in our comprehensive and competitive mix of pay and benefits investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include :

For more information, visit https : / / jobs.cvshealth.com / us / en / benefits

We anticipate the application window for this opening will close on : 11 / 15 / 2025

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex / gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.