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

This position will be working with a Team that is responsible for the development and execution of retail network and mail pricing for CVS Health, a Fortune Six Company.

The Network Pricing Manager will lead and direct complex initiatives as a subject matter expert within Network Operations in areas of: retail, mail and specialty pricing, claims adjudication, and business rules and implementation processes. Tasks include, but are not limited to interpreting and developing workflow frameworks with documentation of auditable inputs and quality review steps for pricing implementations, documenting and executing sophisticated client pricing requirements, performing complex claim data analyses and communicating results to different levels in the organization. The manager will translate complex issues for different audience levels, assist with operational processes during peak/seasonal times, lead and direct team resources, and leverage new and existing technologies for process enhancements and quality improvements.

Additionally, this role serves as a cross-functional liaison and change agent across various business areas such as Account Management, IT, Client Operations, Government Services, Implementations, Benefits, and CVS Health Senior Leaders. Managing multiple priorities and projects within tight deadlines is essential. Critical thinking is key to driving decisions that can impact company revenue within a Sarbanes-Oxley and SAS-70 environment. Strong interpersonal, relationship, and communication skills are essential to resolve daily challenges and to maintain client satisfaction.

Required Qualifications
5+ years of operational experience within PBM or Health Care industry.

Preferred Qualifications

• 8+ years PBM or Health Care industry experience.
• Six Sigma belt certification.
• Audit and/or quality assurance experience.
• Knowledge of CVS Caremark network programs and procedures, including knowledge of retail pharmacy operations and claims adjudication proficiency.
• Fundamental project management knowledge and/or demonstrable experience.
• Operations experience in a volume heavy environment with strict deadlines.
• Intermediate to advanced interpersonal skills as demonstrated by successful collaboration to achieve common and shared goals across business teams.
• Strong time management skills, evidenced by experience being accountable to multiple deliverables on staggered deadlines.
• Intermediate to advanced proficiency in MS Office Suite of tools. Advanced proficiency in Excel and Access desired.
• Effective communication skills in both formal and informal written communications and speech at all levels of an organization.

Education

Bachelor’s degree or equivalent experience required.

Anticipated Weekly Hours

Time Type

Pay Range

The typical pay range for this role is:

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

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:

• Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.

• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.

• Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.

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

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.