Network Management Analyst

The Analyst - Pharmacy Network Non-Compliance is responsible for investigating and resolving complex and sensitive pharmacy contract non-compliance allegations. This role requires a highly motivated, detail-oriented individual with the ability to manage multiple priorities effectively.

The Analyst will conduct outreach to network pharmacies, evaluate non-compliance concerns, and collaborate with cross-functional partners and ensure compliance with contractual and regulatory requirements, while maintaining strong relationships and delivering excellent service.

Key Responsibilities

• Investigate and resolve pharmacy contract non-compliance allegations , including complex and sensitive cases

• Conduct outreach to pharmacies to gather information and address identified issues

• Analyze claims data and adjudication results to support findings and recommendations

• Partner with Sales, Account Management, and other internal teams to coordinate resolution efforts

• Prepare detailed written responses for plan sponsors, participants, and internal stakeholders

• Address and resolve customer concerns related to network pharmacy performance

• Maintain thorough documentation of investigations and outcomes

• Manage multiple cases simultaneously while meeting deadlines and maintaining accuracy

• 3+ years of retail pharmacy experience

• 2+ years of claims adjudication research experience

• 2+ years of experience with Microsoft Office applications (Excel, Outlook, Word)

• Bachelor’s degree required.

Preferred Qualifications

• 2+ years of Pharmacy Benefit Management (PBM) experience

• Experience contacting pharmacies and managing challenging or escalated conversations

• Strong knowledge of pharmacy operating systems and claims adjudication software

• Excellent oral and written communication skills with strong attention to detail

• Demonstrated **critical thinking and analytical skill

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.