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Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as what we deliver. Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.

Position Summary:

Caremark is the nation's leading pharmacy benefit manager (PBM). We work to ensure the path to better health is affordable, easy to access, and simple to follow, for our 103 million plan members. We provide personalized support to help people start and stay on their medications, because people who take their medications have better outcomes and lower health care costs.

Caremark is recruiting for an Executive Director of Aetna Pharmacy Solutions who is responsible for end-to-end delivery of Aetna’s Medicaid, Medicare, and SSI EGWP Pharmacy Benefits Operations through the responsibility and accountability for delivery of the plan administration, requirements, configuration, clinical and quality. The Executive Director has ownership of the successful delivery of Exchange Benefits serving 20+M members and $17B in revenue ensuring predictable high-quality outcomes are achieved aligned with client expectations. The Executive Director is directly accountable for ensuring that all plan administration work is managed in accordance with CVS Health standards and in accordance with agreements contracted with the clients.

Responsibilities:

You’ll make an impact by:

• Managing the annual operating budget of more than $15M.

• Protecting the contractual guarantees and avoidance of millions of service warranties that would arise from faulty installation.

• Leading a team of 100 full time colleagues plus contractors and management across multiple vendor relationships.

• Building a high-performing team by providing colleagues with opportunities, guidance, and feedback to and creating a pipeline of talent for future growth is critical to success.

• Working closely with clients, sales and account management on pharmacy products and handling quality benefits outcomes for over 60 clients.

• Accountability for ensuring that all plan administration work in accordance with CVS Health standards and in accordance with agreements contracted with the clients.

• Supporting CVS Health in attracting, retaining, and engaging a diverse and inclusive consumer-centric workforce that delivers on our purpose and reflects the communities in which we work, live, and serve.

Education:

Bachelor’s Degree, or equivalent years’ experience. Master’s Degree preferred.

Qualifications:

The candidate will have a strong work ethic, be a self-starter, and be able to be highly productive in a dynamic, collaborative environment. This position offers broad exposure to all aspects of the company’s business, as well as significant interaction with all the business leaders. The candidate will be expected to have the following key attributes:

• 10+ years of experience in Pharmacy Benefit Management (PBM), including how a PBM operates and delivers value to clients.

• 5+ years of experience in Benefit and Clinical Operations including how benefits and clinical programs are designed and implemented.

• 7+ years of experience in extensive understanding of the relationship between the supporting functions of the PBM – including the implications of implementing and supporting Commercial regulatory healthcare components at the Federal and State Level to ensure CVS and Client adherence to all requirements.

• 5+ years of experience in large and strategic installation and maintenance process – including responding to RFPs offered by prospective clients and performance guarantee avoidance.

• 5+ years of experience in Program and Project Management, and the creation and management of integrated plans that must be built and managed – with the clients – to ensure predictable outcomes.

• 10+ years of experience influencing across functions and all levels of an organization.

• 10+ years of progressive leadership experience, managing large or multiple teams, with budget/capital management responsibilities.

• 7+ years of experience leading large integrated project plans and driving IT development of systems to meet specific business needs.

• 5+ years of experience in recent resource management (e.g., FTE and vendor).

• Ability to work Hybrid Model (in office Tuesday / Wednesday / Thursday) if reside near a CVS office.

• Demonstrate a commitment to diversity, equity, and inclusion through continuous development, modeling inclusive behaviors, and proactively managing bias.

Preferred Qualifications:

• Knowledge of current tools or applications used to manage Benefit Operations – such as RxClaim, Formulary Management System, SFDC, Tableau, industry advancements in core PBM & clinical functionality (such as use of AI for adjudication).

• Familiarity with software development life cycle.

• Formal Process Improvement methodologies (such as LEAN/SS, CMM-I, ISO).

Pay Range

The typical pay range for this role is:

$131,500.00 - $303,200.00

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. This position also includes an award target in the company’s equity award program. In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off (“PTO”) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies. For more detailed information on available benefits, please visit jobs.CVSHealth.com/benefits

We anticipate the application window for this opening will close on: 04/27/2024

CVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated.

You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.

CVS Health is committed to recruiting, hiring, developing, advancing, and retaining individuals with disabilities. As such, we strive to provide equal access to the benefits and privileges of employment, including the provision of a reasonable accommodation to perform essential job functions. CVS Health can provide a request for a reasonable accommodation, including a qualified interpreter, written information in other formats, translation or other services through ColleagueRelations@CVSHealth.com If you have a speech or hearing disability, please call 7-1-1 to utilize Telecommunications Relay Services (TRS). We will make every effort to respond to your request within 48 business hours and do everything we can to work towards a solution.

We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.