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Position Summary:

Responsible for successful execution and delivery associated with leading large scale Medicare Part D product benefit implementation inclusive of testing for thoroughness of final outcomes for accurate adjudication.  Collaborates with internal stakeholders (i.e., Part D Product departments, Clinical, PBM, etc.) to ensure a smooth and efficient implementation process. Provides guidance and support to the team, resolves escalated issues, and effectively communicates with internal departments to ensure high level satisfaction during the implementation phase.

**Hybrid opportunity in any office location.

Key Components:

• Proactively manage assignments independently and cross functionally

• Provides direction for the implementation of complex Individual and Group Part D pharmacy benefits.

• Creates and manages project plans, timelines, and resource allocations to ensure efficient and effective plan.

• Conducts program implementation risk assessments and develops mitigation strategies to proactively manage project risks.

• Collaborates with multiple departments to gather requirements, design solutions, and manage dependencies and integration.

• Develops key strategies for process improvements to enhance the efficiency and effectiveness of implementation processes.

Requirements/Qualifications:

• Minimum 5+ years of PBM pharmacy experience and functions, and/or health plan experience coordinating pharmacy design builds and testing.

• Minimum 3-5 years of solid Medicare Part D guidance & knowledge

• Minimum 2 years Rx claims adjudication system testing for accuracy.

• Minimum 5 years’ experience managing complex projects.

• 2 years drug benefit configuration in claim adjudication system(s)

• 2-3 years understanding and using automated/BOT technology in testing environment.

• Strong demonstrated problem-solving and analytical skills with attention to detail.

• Advanced Microsoft Office Suite experience

• Strong matrix management skills and demonstrated experience.

• Well-organized self-starter who embraces being a Part D subject-matter-expert

• Demonstrated strong written and oral communication style.

Education:

• Bachelor’s degree preferred in an appropriate area of knowledge (e.g., healthcare, business, IT, etc.)/specialized training/relevant professional qualification.

• Prefer Master of Arts/Science degree in an appropriate area of knowledge (e.g., health care, business administration, IT, etc.)

Pay Range

The typical pay range for this role is:

$82,940.00 - $182,549.40

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 Benefits | CVS Health

We anticipate the application window for this opening will close on: 11/11/2024

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