[Hiring] Senior Analyst, Financial Operations - PDE Reporting @CVS Health

Role Description

This position is responsible for reviewing claims and PDE (Prescription Drug Event) errors. Responsibilities include:

• Analyzing and distributing the PDE Rejections reports and analysis to internal and external clients.
• Serving as liaison between the PDE Reporting Team, PDE Eligibility/Reconciliation, and all entities involved directly or indirectly with PDE to ensure timely and accurate resolution of PDE Rejections.
• Downloading and reviewing the Acumen Outliers.
• Coordinating the research with various departments and submitting the responses to external clients or Acumen according to CMS deadlines.
• Assisting with the weekly PDE meetings.
• Ensuring continuous improvement of Medicare claims data through root cause and impact analysis of errors, and recommendations for systems and procedure enhancements.
• Relying upon business knowledge, including industry concepts and practices, technical skills, and prior experience to plan and accomplish goals.
• Having working knowledge of Part D plans and being able to study and correctly interpret CMS Guidance.
• Reviewing guidance and ensuring compliance with CMS.

Qualifications

• 3 years minimum experience with government-regulated health programs within financial operations and/or related experience (Medicaid, Medicare, and/or Exchanges).

Requirements

• Excellent written and verbal communication skills for interaction with clients, internal partners, and government agencies.
• Strong organizational skills and ability to manage multiple projects simultaneously.
• Excellent time management skills as these requests are time sensitive.
• Proficiency with Microsoft Word and Excel.
• Proficiency with SQL and/or Python.

Education

• Bachelor's degree preferred or equivalent work experience required.

Anticipated Weekly Hours

• 40

Time Type

• Full time

Pay Range

The typical pay range for this role is:

• $46,988.00 - $112,200.00

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.

Benefits

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.
• Other resources, based on eligibility.

Additional details about available benefits are provided during the application process.

Application Window

We anticipate the application window for this opening will close on: 11/27/2026.

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