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Pharmacy Benefit Manager Data Analyst – Meritain Health
| Company | CVS Health |
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| Location | Cheektowaga, NY, USA |
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| Salary | $18.5 – $42.35 |
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| Type | Full-Time |
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| Degrees | |
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| Experience Level | Mid Level |
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Requirements
- 2-4 years of experience with data analysis and/or auditing.
- 2-4 years of experience in the healthcare industry.
- High school diploma or GED.
Responsibilities
- Initiates investigation of plan set-up and overapplied accumulators by running reports from the claim processing system and conducting thorough audits.
- Identifies and coordinates plan set-up corrections and updates.
- Identifies and coordinates adjustments for member accumulators.
- Audits HRA overages and coordinates adjustments for any impacted claims.
- Communicates with internal partners and PBM vendors, addressing inquiries, resolving issues, and providing accurate information regarding prescription claims data and accumulator overages.
- Maintains electronic records, updates information, and ensures compliance with relevant policies and regulations.
- Assists with process improvements implementation to enhance efficiency and effectiveness.
- Provides a high degree of customer service to clients during claims reviews and similar account-specific sessions.
Preferred Qualifications
- 1-2 years of PBM experience.
- 5+ years of experience with data analysis and/or auditing.
- Demonstrated proficiency in Microsoft Excel.
- Strong attention to detail.
- Ability to independently handle multiple assignments competently, accurately, and efficiently.
