Hispanic Alliance for Career Enhancement
Lead Director, Product Mgt & Development - Medicare (Pharmacist)
Hispanic Alliance for Career Enhancement, Lincoln, Nebraska, United States, 68511
At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.
As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.
Position Summary Directs the formulation, implementation and milestone tracking for business plans as Part of the Medicare benefit and product cycle. Directs the strategic development and implementation of large product initiatives, including new products and product enhancements for Medicare pharmacy business strategic plans, product implementation, regulatory oversight Medicare PDP, MAPD, DSNP for both individual and employer plan types. Represent Medicare Pharmacy and Product strategic issues with within Medicare matrix partners in addition to PBM, cross functional Aetna pharmacy Organization and Executive leadership. As a highly regulated function, this role will also oversee delegated PBM functions, cross Medicare Pharmacy Organizational Compliance with CMS regulations as well as pharmacy functions required for various state contracts for our growing DSNP market.
This role requires an active, unrestricted Pharmacist license in good standing.
What you will do
Cultivates and develops relationships with key constituents independently or in concert with Health Plan and/or Enterprise senior leaders
Directs the formulation, implementation and milestone tracking for business plans
Leverages in-depth knowledge and understanding of Medicare products across functions and market segments in directing the development and implementation of new product initiatives, including product enhancements
Directs and evaluates requirements and specifications in building appropriate business and clinical processes and systems to support product initiatives
Incorporates results into strategic plan development and on-going product performance monitoring Consult on / drive effective product offerings to meet organizational goals and compliance requirements.
Directs the establishment of large cross functional development and implementation work groups, encouraging innovative use of resources to achieve objectives consistent with the
Encourages cross-functional collaboration, supporting information needs to solve business issues and support project requirements
Recruits and selects well-qualified, diverse and talented management staff Identifies long term needs of the organization and establishes succession plans for key personnel Maintains environment and reward system that encourages initiative, learning and empowerment
Articulates performance expectations and team objectives while collecting and interpreting balanced measures to evaluate team performance
Communicates and consults with Senior Management to ensure that product initiatives focus on long term results/ earnings and represent all constituencies effectively (e.g. segments, consumers, providers)
This is a remote role open to qualified candidates within the United States.
Required Qualifications
10+ years of Managed Care experience in health plan and/or PBM roles
10+ years Medicare experience
CMS audit experience
HPMS experience
Preferred Qualifications
15+ years of Managed Care experience in health plan and/or PBM roles
15+ years Medicare experience
Education Pharmacist, BS or Pharm D with active, unrestricted license in good standing
Pay Range The typical pay range for this role is:
$100,000.00 - $231,540.00
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.
Benefits Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
Great benefits for great people
We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:
Affordable medical plan options,
a
401(k) plan
(including matching company contributions), and an
employee stock purchase plan .
No-cost programs for all colleagues
including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
Benefit solutions that address the different needs and preferences of our colleagues
including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.
For more information, visit the CVS Health benefits page; this description preserves the original URL: https://jobs.cvshealth.com/us/en/benefits
We anticipate the application window for this opening will close on: 10/30/2025
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
#J-18808-Ljbffr
As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.
Position Summary Directs the formulation, implementation and milestone tracking for business plans as Part of the Medicare benefit and product cycle. Directs the strategic development and implementation of large product initiatives, including new products and product enhancements for Medicare pharmacy business strategic plans, product implementation, regulatory oversight Medicare PDP, MAPD, DSNP for both individual and employer plan types. Represent Medicare Pharmacy and Product strategic issues with within Medicare matrix partners in addition to PBM, cross functional Aetna pharmacy Organization and Executive leadership. As a highly regulated function, this role will also oversee delegated PBM functions, cross Medicare Pharmacy Organizational Compliance with CMS regulations as well as pharmacy functions required for various state contracts for our growing DSNP market.
This role requires an active, unrestricted Pharmacist license in good standing.
What you will do
Cultivates and develops relationships with key constituents independently or in concert with Health Plan and/or Enterprise senior leaders
Directs the formulation, implementation and milestone tracking for business plans
Leverages in-depth knowledge and understanding of Medicare products across functions and market segments in directing the development and implementation of new product initiatives, including product enhancements
Directs and evaluates requirements and specifications in building appropriate business and clinical processes and systems to support product initiatives
Incorporates results into strategic plan development and on-going product performance monitoring Consult on / drive effective product offerings to meet organizational goals and compliance requirements.
Directs the establishment of large cross functional development and implementation work groups, encouraging innovative use of resources to achieve objectives consistent with the
Encourages cross-functional collaboration, supporting information needs to solve business issues and support project requirements
Recruits and selects well-qualified, diverse and talented management staff Identifies long term needs of the organization and establishes succession plans for key personnel Maintains environment and reward system that encourages initiative, learning and empowerment
Articulates performance expectations and team objectives while collecting and interpreting balanced measures to evaluate team performance
Communicates and consults with Senior Management to ensure that product initiatives focus on long term results/ earnings and represent all constituencies effectively (e.g. segments, consumers, providers)
This is a remote role open to qualified candidates within the United States.
Required Qualifications
10+ years of Managed Care experience in health plan and/or PBM roles
10+ years Medicare experience
CMS audit experience
HPMS experience
Preferred Qualifications
15+ years of Managed Care experience in health plan and/or PBM roles
15+ years Medicare experience
Education Pharmacist, BS or Pharm D with active, unrestricted license in good standing
Pay Range The typical pay range for this role is:
$100,000.00 - $231,540.00
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.
Benefits Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
Great benefits for great people
We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:
Affordable medical plan options,
a
401(k) plan
(including matching company contributions), and an
employee stock purchase plan .
No-cost programs for all colleagues
including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
Benefit solutions that address the different needs and preferences of our colleagues
including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.
For more information, visit the CVS Health benefits page; this description preserves the original URL: https://jobs.cvshealth.com/us/en/benefits
We anticipate the application window for this opening will close on: 10/30/2025
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
#J-18808-Ljbffr