Manages pharmacy reimbursement strategy and finance analytics, including complex contract modeling, pricing recommendations, payer benchmarking, dashboards, and performance reporting. Partners with Finance, Payer Relations, data warehouse, IT, product, operations, supply chain, and other teams to support negotiations, CostVantage implementation, pricing models, and process improvements. Communicates analytical insights and recommendations to senior leadership while serving as a subject matter expert for pharmacy reimbursement and payer finance.
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
The Manager of Pharmacy Reimbursement Strategy and Finance is a key role in the Payer Relations Analytics organization. With the constantly evolving Pharmacy Reimbursement landscape, and the launch of the CVS CostVantage model, there is a vital need for comprehensive and real-time analytics across both the internal organization and external market dynamics. The Manager will partner closely with the Senior Manager of Pharmacy Strategy and Analytics to provide these key insights and develop pricing recommendations for senior leadership.
The Manager can expect to develop and utilize strong analytical skills to quantify the value of contract opportunities, benchmark performance, and collaborate with the Payer Relations team to inform negotiations. The Manager will also be responsible for leading regular reporting on business performance and developing process improvements to move toward more accurate modeling and efficient sharing of insights.
- Assist in development of next-generation CostVantage pro forma model to align to financials from Finance and give all the needed outputs to support Payer Relations team
- Develop new benchmarking techniques and dashboards
- Partner cross-functionally with Finance and data warehouse teams to enhance processes for integrating drug pricing data
- Oversee and support modeling new pricing models across all lines of business in 2027 and beyond
- Liaison with Payer Relations Team to incorporate emerging business needs into process and modeling
This role will develop strong relationships across the retail organization to provide subject matter expertise and ad hoc analytics to cross-functional business partners including: broader finance organization, product development, operations, supply chain, and real estate.
Approximate breakdown of responsibilities
60% Contract analytics & modeling: Develop complex deal models and underwriting in collaboration with Payer Relations team to support contracting negotiations for >100 payers and Pharmacy Benefits Managers. Apply strong analytical skills and business acumen to benchmark deal projections and analyze performance over time. Communicate recommendations, summaries, and nuances of analysis to senior leadership.
20% Project management: Implement technical and personnel processes required to transition to CostVantage model, including working with business and IT stakeholders. Support reporting for vaccine financials, setting cash prices, and other reimbursement processes.
20% Develop subject matter expertise & conduct ad hoc analytics: Support broader finance, product development, operations, and supply chain organizations with payer finance knowledge and ad hoc analytical insight and recommendations. Assess financial impact of proposals from across the Retail and PBM organizations.
Required Qualifications
- 3-5 years work experience in health care, finance, consulting, business analytics or related quantitative problem solving
- Strong analytical skillset and approach to problem solving
- Strong financial modeling skills - Ability to build, maintain, and interpret complex deal models and quantify financial impacts
- Strong communication skills and ability to drive recommendations to leadership through impactful, insightful analytical-based presentations
- Ability to become trusted advisor to cross-functional business partners
- Ability to focus on long-term, strategic goals while executing against short-term objectives
- Ability to develop a deep understanding of the industry
- 1- 2 years SQL experience
Preferred Qualifications
- Experience in Consulting or Finance
- Experience with AI
Education
Bachelor’s degree required
Anticipated Weekly Hours
40Time Type
Full timePay Range
The typical pay range for this role is:
$54,300.00 - $145,860.00This 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.
Additional details about available benefits are provided during the application process and on Benefits Moments.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
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