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CVS Health Pharmacy Compliance Health Plan Leader in Hartford, Connecticut

Job Description

As a Pharmacy Business Compliance Solutions Leader, you will support the Aetna Pharmacy Health Plan Business Integrity Unit which is responsible for managing Pharmacy business compliance with state and Federal regulations. Furthermore, you will be responsible for leading multiple large-scale Pharmacy Compliance projects at the same time including coordination, planning, development, implementation, and financial impact analysis. Some other essential components of this role include being accountable for establishing and managing cross-functional implementation workgroups, anticipating business and resource needs, setting priorities, establishing accountabilities, and managing relationships which are not under your direct control. Also you will work independently to identify requirements, to research and resolve barriers to progress, and to influence team members to work with urgency. Ideally, you will become the Pharmacy Compliance Business Subject Matter Expert (SME) on regulations which impact the Pharmacy Health Plan business and will proactively assist team members to identify solutions to issues that negatively impact the Pharmacy Health Plan's ability to deliver compliant solutions.

Required Qualifications

  • 8 years or more of healthcare and pharmacy experience- At least 8 years or more of project management, project implementation and/or project consultation experience

Preferred Qualifications

  • Experience with Business Process Redesign (ABX or 6 Sigma)- Healthcare systems and processes, technology experience - Broad knowledge and understanding of the Health Plan and Pharmacy Benefit Management regulatory environment - Strong analytical skills- Pharmacy Systems and Operations experience- Rx Eligibility and RxClaim experience - Program Management experience (PMP Preferred)- Proficient in MS Office, Excel, Word, PowerPoint- Ability to understand complex compliance problems and collaborate with business leaders and IT to plan, solve, and execute solutions- Strong technical background working with and driving IT teams and business teams to aggressive timelines- Ability to lead multiple high-visibility projects at the same time in a fast paced environment- Excellent written and oral communication skills

Education

Bachelor’s degree from an accredited college is 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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