Great healthcare opportunity to join a growing Fortune 7 company with unlimited exposure to many facets of pharmacy and healthcare! This Healthcare role (Senior Network Consultant) is responsible for the development and execution of pharmacy networks and mail pricing for CVS Health.
In this position, you will be a subject matter expert for the pharmacy network products and pricing team managing the pricing information across our Client's Employer, Government and Health Plan business segments. You will have the opportunity to partner cross-functionally with both internal and external business partners for implementations and maintenance of business support, and will assist in supporting new and innovative future product projects and technologies.
This position will also be responsible for, but not limited to:
Managing the implementation of accurate client pricing, including retail and mail pricing parameters (discounts, fees, MAC) and adjudication logic
Analyzing client and product specifics, including claim data and client set up on the adjudicating platform, to decide appropriate direction for implementation of new pricing
Researching, reporting and providing solutions to address issues on complex client set ups
Providing ongoing training and education on new products and procedure changes and for complex data analysis and query needs on systems such as AS400
Supporting the development and roll out of network products and pricing IT functionality and process enhancements on all adjudication platforms and tools
Generating innovative solutions utilizing available tools and resources such as SQL, MS Excel and MS Access, working with Pricing technical SME's as needed
Assist product owners on development, implementation, maintenance, and monitoring of new or modified network products
CVS Health is proud to offer our colleagues a career with plenty of room for growth, a strong company culture, as well as a competitive and customizable benefits package. This is the perfect time to join one of the world's largest and fastest-growing industries and join a company dedicated to helping people on their path to better health.
Must have 1+ years of analytics experience, which includes extensive experience with Microsoft products (Excel/PowerPoint) and the ability to build analytic portfolios
Must have at least 1 year of healthcare experience with exposure to healthcare claims and/or auditing
Bachelor Degree in Business, Pharmacy or relevant discipline or equivalent experience
CVS Health, through our unmatched breadth of service offerings, is transforming the delivery of health care services in the U.S. We are an innovative, fast-growing company guided by values that focus on teamwork, integrity and respect for our colleagues and customers. What are we looking for in our colleagues? We seek fresh ideas, new perspectives, a diversity of experiences, and a dedication to service that will help us better meet the needs of the many people and businesses that rely on us each day. As the nation's largest pharmacy health care provider, we offer a wide range of exciting and fulfilling career opportunities across our three business units MinuteClinic, pharmacy benefit management (PBM) and retail pharmacy. Our energetic and service-oriented colleagues work hard every day to make a positive difference in the lives of our customers.
CVS Health is an equal opportunity employer. We do not discriminate in hiring or employment against any individual on the basis of race, ethnicity, ancestry, color, religion, sex/gender (including pregnancy), national origin, sexual orientation, gender identity or expression, physical or mental disability, medical condition, age, veteran status, military status, marital status, genetic information, citizenship status, unemployment status, political affiliation, or on any other basis or characteristic prohibited by applicable federal, state or local law. CVS Health will consider qualified job candidates with criminal histories in a manner consistent with federal, state and local laws. CVS Health will not discharge or in any other manner discriminate against any Colleague or applicant for employment because such Colleague or applicant has inquired about, discussed, or disclosed the compensation of the Colleague or applicant or another Colleague or applicant. Furthermore, we comply with the laws and regulations set forth in the following EEO is the Law Poster: EEO IS THE LAW and EEO IS THE LAW SUPPLEMENT
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CVS Health does not require nor expect that applicants disclose their compensation history during the application, interview, and hiring process.
For inquiries related to the application process or technical issues please contact the Kenexa Helpdesk at 1-855-338-5609. For technical issues with the Virtual Job Tryout assessment, contact the Shaker Help Desk at 1-877-987-5352. Please note that we only accept resumes via our corporate website: https://jobs.cvshealth.com/