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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

As the Executive Director of Retail Network Operations, you will be the senior business leader overseeing the end-to-end claims adjudication processes for the CVSH retail pharmacy business. You will be responsible for a team consisting of 3-5 direct reports and up to 40 total colleagues responsible for ensuring the success of the CVSH retail claims adjudication network. This encompasses various strategic functions from industry standardization and relations, technical innovation and modernization of billing processes, continuous quality improvement and delivery of critical financial and customer experiential outcomes. This leader will regularly interface with the most senior levels of the organization, industry associations and external clients while maintaining a close connection with operators in the store and all levels of field hierarchy. 

As the Senior Leader, you will need to develop strategies and manage a multi-million-dollar expense and capital budget that prioritizes compliance and safety as well as colleague engagement. To be successful, this individual must balance delivery of financial outcomes with ensuring in-store processes are effectively and compliantly executed by pharmacy teams. This includes but is not limited to all third-party payer contract and regulatory compliance obligations. These outcomes will be achieved through extensive collaboration with stakeholders across CVSH and externally within the industry. 

This leader will regularly interface with the most senior levels of the organization, industry associations and external clients while maintaining a close connection with operators in the store and all levels of field hierarchy. 

Responsibilities:

The successful candidate will have a strong work ethic, be a self-starter, and able to be highly productive in a dynamic, collaborative environment. The ideal candidate will have the following knowledge / skill / ability: 

  • Highly responsible and accountable for building strong business value 
  • Consistently leads by example and contributes to overall team success through a positive mindset and resiliency 
  • Expertise leveraging MS Office Suite, including advanced Excel and PowerPoint capabilities 
  • Passion for Health Care: A history of work in the health care industry and an ongoing desire to make one of the world’s strongest health care companies even stronger. 
  • Proven track record of the ability to work collaboratively with internal and external business partners to deliver ROI from effective targeting and communication strategies. 
  • Strong executive presence and business acumen 
  • Excellent verbal and written communication skills, including presenting to large audiences and senior leaders 
  • Balancing, coordinating, and executing multiple competing priorities across multiple stakeholders 
  • Influencing without authority to align multiple stakeholders to a common goal and hold teams accountable for delivering results 
  • Translate vision and strategy into actionable timelines and produce successful outcomes 
  • Framing complex problems and developing solutions that address multiple interests with minimal guidance or direction 
  • Identifying risk and mitigation strategies to ensure success 
  • Using critical thinking and strategy to balance multiple stakeholders needs (e.g. patient, customer, executives, business owners, enterprise) 

Required Qualifications:

  • 15+ years’ experience in retail pharmacy operations or like fields (e.g. payer relations, payer operations) 
  • 15+ years demonstrated leadership experience in managing innovation operations on a large scale 
  • Managing short term objectives while leading through the long-term strategic vision 
  • Building high-performing, resilient teams 
  • Building and implementing strategies that require strong collaboration across different business functions, perspectives, and leadership styles 
  • Managing multiple priorities to completion, solving complex problems with an operational environment 
  • Leading cross-functional teams and initiatives with a high degree of complexity 
  • Developing strategies to mobilize the business to achieve goals and outcomes using innovative solutions 
  • Influencing with and without authority 
  • Working with a team to prioritize work based on skills, needs, timelines, etc. 
  • Engaging and inspiring a team to reach optimal business outcomes together 
  • Regular and reliable attendance during normal working hours, as established by the leader 
  • Hybrid worker – in office Tuesday through Thursday – work from home Monday & Friday 
  • Travel requirements – up to 20% travel expected, as needed by the business 

Preferred Qualifications:

  • Deep understanding of retail pharmacy operations including but not limited to regulatory compliance, professional practices 
  • Deep understanding of central operations strategy and implementation including experience delivering broad scale innovation to market 
  • Background on industry standardization particularly the NCPDP TELECOM D.0 standard 
  • Strong analytical skills and the ability to turn insights into tangible, multi-year plans 
  • Proven ability to solve emerging problems quickly and strategically 
  • Proven ability to deliver results both directly and through strategic influence 
  • Excellent prioritization and planning skills 
  • Doctorate in Pharmacy or Bachelor’s degree in Pharmacy is preferred
  • Licensed Pharmacist with clinical experience 
  • Master’s degree 

Education

Bachelor’s degree, or equivalent experience is required

Doctorate in Pharmacy or Bachelor’s degree in Pharmacy or Master's degree is preferred

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: 04/08/2024

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. 

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Confirmed 20 hours ago. Posted 5 days ago.

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