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Network Management - Senior Analyst

CVS Health

🌍 Anywhere 🏠 Remote ⏱ Full-time 💼 Senior 🗓 1 weeks ago

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary This position supports a Network Pricing team responsible for quality assurance and execution oversight of pharmacy network and pricing implementations for a single, dedicated PBM client across all lines of business. The Sr. Analyst ensures accuracy and compliance of pricing implementations across retail and mail pharmacy networks. The role is focused on validating the correct application of business rules, implementation processes, network structures, and pricing documents across supported delivery systems and adjudication platforms. In addition to QA/QC review activities, the Sr. Analyst provides operational support through review of implementation artifacts (e.g., Network Implementation Forms), downstream system validations (e.g., AS400 network profile coding validations), issue resolution, and ad‑hoc production support as needed. Success in this role requires strong attention to detail, the ability to manage multiple deadlines in a volume-driven environment, and comfort working both independently and collaboratively. Advanced Excel skills and the ability to interpret pricing and network data are essential. Key Responsibilities Perform quality assurance reviews of pharmacy network and pricing implementations to ensure alignment with approved pricing documents, business rules, and network structures Audit upstream implementation artifacts (e.g., network pricing forms, configuration inputs) and downstream system outputs to validate accurate execution Support post‑implementation validation activities, including sys...

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