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Executive Director, Pharmacy Benefit Operations
Executive Director, Pharmacy Benefit Operations-April 2024
Northbrook
Apr 24, 2025
ABOUT CVS HEALTH
CVS Health is a healthcare innovation company. Together, we are helping people on their path to better health.
10,000+ employees
Healthcare
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About Executive Director, Pharmacy Benefit Operations

  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 Pharmacy Benefit Operations who is responsible for end-to-end delivery of pharmacy client solutions health plan, requirements and operations through the responsibility and accountability for distribution of the plan administration, requirements, configuration, clinical and quality. This leader will have ownership ensuring predictable high-quality outcomes are achieved and aligned with client expectations.

  You’ll make an impact by:

  Leading our Requirements Health Plan Benefit and Clinical Operations business unit.

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

  Safeguarding 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, as well as 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.

  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.

  Required 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 Pharmacy Benefit Manager (PBM), Pharmacy Operations, or Healthcare experience.

  Ability to work Hybrid Model (in-office Tuesday / Wednesday / Thursday).

  Experience in large and strategic installation and maintenance process – including responding to RFPs offered by prospective clients and performance guarantee avoidance.

  Program and project management experience and the creation and management of integrated plans that must be built and managed – with the clients – to ensure predictable outcomes.

  Influencing across functions and all levels of an organization.

  Progressive leadership experience, managing large or multiple teams, with budget/capital management responsibilities.

  Managing client relationships.

  Leading large integrated project plans and driving IT development of systems to meet specific business need.

  Recent resource management (e.g., FTE and vendor).

  Demonstrated 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).

  Formal process improvement methodologies (such as LEAN/SS, CMM-I, ISO).

  EducationBachelor's degree required or equivalent work experience.

  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

  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 [email protected] 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.

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