Network Management - Senior Analyst

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 system profile reviews and issue research
• Identify defects, variances, or risks; document findings and partner with implementation and pricing teams to drive resolution
• Execute recurring and ad‑hoc operational tasks to support production timelines and QA workflows (e.g., Excel-based analysis, macros, reporting)
• Maintain documentation and controls in support of audit, compliance, and regulatory requirements
• Manage multiple deliverables concurrently while meeting strict deadlines
• Communicate findings clearly to peers, leaders, and cross‑functional partners

Required Qualifications

• 3–5 years of operational experience within a PBM or healthcare industry.
• Experience working in a deadline‑driven, high‑volume production or QA environment.
• Intermediate to advanced proficiency in Microsoft Office tools, with strong Excel skills required.
• Strong analytical, organizational, and problem‑solving skills.
• Ability to work effectively both independently and within a team environment.
• Demonstrated written and verbal communication skills.

Preferred Qualifications

• Quality assurance or audit experience within network pricing, pharmacy operations, or related functions.
• Knowledge of PBM network pricing concepts, pharmacy operations, and claims adjudication.
• RxClaim system experience.
• Fundamental project management experience or exposure.

Education

• High School diploma or equivalent experience (required)
• Bachelor’s degree or equivalent experience (preferred)

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is:

$46,988.00 - $102,000.00

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 offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.

This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.

Additional details about available benefits are provided during the application process and on Benefits Moments.

We anticipate the application window for this opening will close on: 06/02/2026

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