Clinical Client Benefits Analyst
Pathways 77 reviews - Irving, TX

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The Analyst within Clinical Client Operations works directly with our Clinical Pharmacists and Senior Analysts as well as our internal business partners to support clinical initiatives. Analyst duties will emphasize data analysis for various programs such as Formulary, Specialty Pharmacy, and Utilization Management, especially related to CVS Caremark standard product lists used for RxCLAIM Adjudication benefits designs. This position is responsible for reviewing and updating RxCLAIM changes for accuracy related to standardized programs. Responsibilities include, but are not limited to: document review, current system validation, trending analysis, and supporting ad hoc situations, including and not limited to: Coding changes into RxCLAIM system as needed; Interface with internal clients via conference calls and written communication; Accountable for ensuring accurate RxCLAIM set up through system testing and validation and following up with internal parties as needed.

- Proficient in use of RxCLAIM adjudication, RxClaim query, MS Access, and MS Excel
- Well organized with the ability to effectively prioritize work
- Ownership and results driven
- Customer focused
- Attention to detail
- Able to meet aggressive turnaround time standards/client performance guarantees coupled with excellent quality
- Ability to effectively work within a team
- Flexible in adapting to change
- Demonstrated ability to analyze data and determine conclusions
- Ability to learn and apply increasingly complex concepts, policies and procedures
- Ability to effectively plan, prioritize, organize time and workload
- Skilled in identifying and solving issues and recommending process improvements
- Ability to work successfully in a deadline-oriented environment
- Excellent verbal and written communication skills
- Project Management skills

Minimum 3 years PBM or equivalent experience preferred. Must be able to work with various divisions within the organization.

Verifiable High School diploma or GED is required.

CVS Caremark, through our unmatched breadth of service offerings, is transforming the delivery of health care services in the U.S. We are an innovative, fast-growing company guided by values that focus on teamwork, integrity and respect for our colleagues and customers. What are we looking for in our colleagues? We seek fresh ideas, new perspectives, a diversity of experiences, and a dedication to service that will help us better meet the needs of the many people and businesses that rely on us each day. As the nation’s largest pharmacy health care provider, we offer a wide range of exciting and fulfilling career opportunities across our three business units - MinuteClinic, pharmacy benefit management (PBM) and retail pharmacy. Our energetic and service-oriented colleagues work hard every day to make a positive difference in the lives of our customers.


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77 reviews