
10,000+ employees
Founded 1963
🏥 Healthcare
⚕️ Healthcare Insurance
🛒 Retail
Healthcare • Healthcare Insurance • Retail
CVS Health is a leading American healthcare company dedicated to improving health access and affordability. The company focuses on a comprehensive approach that includes health services, health insurance, and pharmacy benefits management. Through its subsidiaries, such as Aetna and CVS Caremark, CVS Health offers a range of services that facilitate wellness, condition management, and affordable prescription drug coverage. CVS Health operates neighborhood pharmacies, provides mail-order pharmacy services, and manages specialty medication programs, aiming to make healthcare convenient and accessible for everyone. Driven by a mission to connect people with essential care services, CVS Health is committed to fostering healthier communities and supporting the wellbeing of all individuals.
🕒 September 17
Where this job comes from
Posted on CVS Health's careers page, not through a job board
First seen by Remote Rocketship September 17

10,000+ employees
Founded 1963
🏥 Healthcare
⚕️ Healthcare Insurance
🛒 Retail
Healthcare • Healthcare Insurance • Retail
CVS Health is a leading American healthcare company dedicated to improving health access and affordability. The company focuses on a comprehensive approach that includes health services, health insurance, and pharmacy benefits management. Through its subsidiaries, such as Aetna and CVS Caremark, CVS Health offers a range of services that facilitate wellness, condition management, and affordable prescription drug coverage. CVS Health operates neighborhood pharmacies, provides mail-order pharmacy services, and manages specialty medication programs, aiming to make healthcare convenient and accessible for everyone. Driven by a mission to connect people with essential care services, CVS Health is committed to fostering healthier communities and supporting the wellbeing of all individuals.
• Review and resolve pharmacy inquiries related to Non-MAC pricing while ensuring compliance with Non-MAC law requirements • Validate pricing and product information using Medispan and wholesaler information • Monitor marketplace conditions and escalate potential issues to leadership • Assist Non-MAC team contractors by answering questions and providing training support • Back up the lead tester by monitoring and performing testing activities for IT system implementations • Research and respond to Department of Insurance inquiries with accurate and timely information for state regulators • Assist management with ad hoc tasks and special projects
• 4 years of Pharmacy Benefit Management (PBM) experience with all non-MAC appeal-related processes, state regulations, and claims adjudication, including claims adjudication logic • Experience with RxClaim platform (AS400) • Bachelor's Degree or equivalent combination of work and experience • Proficiency in Excel, Word, Salesforce, and Pharmacy Porta • Ability to work under tight deadlines • Strong mathematical problem-solving skills • Familiarity with wholesaler invoices • Ability to work 40 hours weekly • Qualified applicants with arrest or conviction records will be considered in accordance with federal, state, and local laws
• CVS Health bonus, commission or short-term incentive program in addition to base pay • Medical coverage • Dental coverage • Vision coverage • Paid time off • Retirement savings options • Wellness programs • Other resources supporting physical, emotional, and financial well-being
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