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CVS Health Clinical Pharmacy - Director in Florida

Job Description

This leadership position requires a proven leader with significant managed care experience in Medicare. The team under this leader is responsible for a Medicare Part D formulary portfolio of solutions solved both in the individual market as well as to retiree groups that include PDP, MAPD and DSNP benefit designs. Key functions include: (1) strategy, implementation, compliance and routine maintenance of formulary requirements for Medicare; (2) routine monitoring and audit ready by maintaining highest business excellence standards; (3) collaboration with PBM, compliance, enterprise and product partners in projects to continue to deliver high quality products and services to our Medicare membership.

Required Qualifications

  • 10+ years in managed care field - 5+ years experience in Medicare Part D business functions- Plan sponsor and/or PBM -CMS program and desk audit experience- Ability to read, interpret and implement CMS requirements for Medicare Plan sponsors-- Management experience of diverse teams- Strong communications skills & dynamic leader- Ability to manage multiple key projects at a time and high quality deliver results - Strategic thinking- Functional knowledge of Microsoft Office-Ability to travel up to 10%

COVID Requirements

COVID-19 Vaccination Requirement

CVS Health requires its Colleagues in certain positions 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, pregnancy, or religious belief that prevents them from being vaccinated.

  • If you are 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 within the first 30 days of your employment. For the two COVID-19 shot regimen, you will be required to provide proof of your second COVID-19 shot within the first 60 days of your employment. Failure to provide timely proof of your COVID-19 vaccination status will result in the termination of your employment with CVS Health.

  • If you are unable to be fully vaccinated due to disability, medical condition, pregnancy, or religious belief, you will be required to apply for a reasonable accommodation within the first 30 days of your employment in order to remain employed with CVS Health. As a part of this process, you will be required to provide information or documentation about the reason you cannot be vaccinated. If your request for an accommodation is not approved, then your employment may be terminated.

Preferred Qualifications

Experience with Rxclaims preferredPrior Medicare experience in both PDP and MAPD product offeringsPrior experience answering clincial RFPs for group salesExperience with clinical programs and strategies for both quality and cost effective pharmacy care

Education

BS in Pharmacy or PharmD required.Managed Care residency or significant MCO experience required.

Business Overview

At Aetna, a CVS Health company, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.

We are committed to maintaining a diverse and inclusive workplace. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, gender, gender identity, age, disability or protected veteran status. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.

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