Job Description Does being on the inside of a transformational organization sound exciting to you? Well, read on! CVS Health is positioned as the nationâ™s premier health innovation company. Through our health services, insurance plans and community pharmacists, weâ™re pioneering a bold new approach to total health. As a CVS Health colleague, youâ™ll be at the center of it all! Weâ™re looking for a finance and underwriting Senior Director who will have the opportunity to drive financial results within a PBM client division of CVS . This leader will act in the same manner as a CFO would align with the CEO of a company in achieving its targets. As the CFO for the business unit, this position has joint responsibility to deliver on the financial goals of the segment, including managing our Client P&L and driving value through Networks, Trade and Sub-Client Pricing. You will lead client discussions that are highly complex financially. This role requires a deep understanding of the pricing/financial levers of our business and have a proven ability to understand the health plan business models. In this role, you will provide direction to a varied team of Analysts and Underwriters who identify and execute opportunities to retain and expand our existing client relationships. Daily activities include monitoring financial performance of the division, providing consultative information and recommendations in plan design, distribution channel, underwriting new pharmacy contracts and seeing opportunities to increase revenue and profit margins. Having experience with health plans that are highly custom in their approach to pharmacy benefit services â“ complex pricing arrangements, custom formularies, clinical programs, channel solutions, and integrated benefit designs. You will communicate with key internal partners such as Sales and Account Management, Trade, Networks, IT and Product Development. The incumbent will directly contact external clients to develop a deep understanding of their business and goals to assist with up selling our products and solutions that align with their strategy. Maintain authoritative knowledge of the PBM P&L, profit levers, underwriting, and financial models to analyze, review and approve client financial offerings that maintain the highest levels of accuracy in forecasting CVS Caremarkâ™s profitability and client savings. They must exercise sound business judgment to achieve proper balance between client wins and CVS Caremark profitability. They must identify areas of potential risk and implement operational improvements to mitigate risk, use data to create compelling value statements on pricing and savings opportunities to assist in closing sales and generating profitable returns to the business. This Sr. Director must possess the ability to lead a division P&L by understanding and supporting organizational financial budgeting, forecasting and close processes. They must create an organizational culture with sound financial judgment and governance throughout all decision-making procedures. You will maintain expert knowledge of the health insurance industry, PBM industry, current/emerging medical and pharmacy trend management strategies, current/emerging enterprise offerings, CVS Caremark data warehouse, drivers of enterprise revenue/profitability and health plan client revenue/profitability. The successful candidate will have a consistent record of building and leading high-performing teams of knowledge-based employees with the necessary eye for business, clinical knowledge and technical skills to contribute to the goals of the business unit. The successful candidate will also have a track record that demonstrates the following abilities: developing and executing strategic business plans, working successfully in a cross-matrix environment, adapting and performing in a dynamic and changing environment, developing and demonstrating a comprehensive understanding of CVS Caremarkâ™s enterprise assets, developing a deep understanding of internal and external goals, maintaining high levels of customer satisfaction, and applying clinical and analytical expertise to make informed recommendations and decisions.
Essential Functions of the job: â¢ Provide domain expertise across the full spectrum of financially-related efforts aimed at retaining clients and growing the revenue and profitability of clients, including leading client renewals, conducting market check pricing, and identifying and communicating opportunities to increase revenue and profit margins across areas such as plan design, channel, clinical, and other solutions â¢ Bring to bear understanding of different lines of business (ex. fully-insured, ASO, Medicaid, Medicare, Exchanges) to provide relevant recommendations and to influence client adoption of custom and standard solutions â¢ Cultivate and maintain relationships with key internal partners within the Division and identify and communicate opportunities to increase revenue and margin at a client-level as well as use data to identify and position opportunities to drive value. â¢ Maintain overall accountability for implementing and overseeing processes to ensure accurate financial modeling with projections for client and internal outcomes â¢ Collaborate with internal partners to develop products and services that bring to bear CVS Caremarkâ™s enterprise assets, differentiate the firm from its retail/PBM competitors, and attract and retain health plan lives â¢ Hire, train, coach, and develop a team of Directors, Managers and Analysts â¢ Promote team diversity both in terms of demographics and ideas. Run cost centers and departmental expenses according to budget â¢Work independently in a fast-paced environment and handle tight deadlines with appropriate level of delegation to team members This position can be based in one of the following corporate hubs: Northbrook, IL, Scottsdale, AZ, Woonsocket, RI or Irving, TX
Required Qualifications â¢ 15+ years of professional experience, preferably within a PBM or health plan or Masters Degree with 12+yrs of relevant experience â¢ Ability to travel approximately up to 40% of the time throughout the country. â¢ 2+ years P&L responsibility â¢ 5+ years Management responsibility
Preferred Qualifications â¢ Previous underwriting or financial analysis and marketing experience â¢ Experience working with health plans, including payers with multiple lines of business with different funding arrangements â¢ Proven track record of implementing efficiencies/solutions developed primarily from input from end users, which successfully satisfy the business need. Demonstrated experience in managing complex work processes in a cross-department, team environment. Demonstrated success and experience in motivating individuals in a complete, fast-paced, high-pressure environment. Demonstrated experience working successfully with Sales and Account Services â¢ Experience working in a geographically diverse company and in a matrix reporting environment â¢ Intimate knowledge of pricing, underwriting activities, and drivers of enterprise/PBM revenue and profitability â¢ Experience working with varying levels of client contacts, including executive leadership, Chief Medical Officers, pharmacy department leadership, provider networks, actuaries, financial analysts and consultants â¢ In-depth understanding of client decision-making and analysis related to drug formularies, utilization management controls, breadth of network access, medical loss ratios, actuarial values, rebates, and plan designs â¢ Understanding of quality measures such as HEDIS and Star ratings and their importance to customers â¢ Ability to weigh both clinical and financial implications of recommendations and decisions. Comprehensive understanding of business analytics and application of data-based decision making â¢ Understanding of healthcare and pharmacy claims data and common tools used to manipulate data â¢ Exceptional communication skills across the full spectrum of formal and informal channels and to multiple audiences, including external clients, consultants, internal partners, and executive leadership. Proven ability to educate and influence external customers and internal partners â¢ Ability to manage and deliver on client expectations within assigned book of business â¢ Broad knowledge of the overall enterprise infrastructure, including operational systems and data warehouses
Education Bachelorâ™s Degree Required. Advanced degree in a relevant field, such as an MBA a plus.
Business Overview At CVS Health, 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 strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, sex/gender, sexual orientation, gender identity or expression, age, disability or protected veteran status or on any other basis or characteristic prohibited by applicable federal, state, or local law. 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.
Internal Number: 1659904BR
About CVS Health
Combining CVS Health and Aetna was a transformative moment for our company and our industry, establishing CVS Health as the nation’s premier health innovation company. Through our health services, insurance plans and community pharmacists, we’re pioneering a bold new approach to total health. As a CVS Health colleague, you’ll be at the center of it all.
At CVS Health, we work every day to help people on their path to better health. Never has it been more important for us to deliver on our purpose to our valued customers, patients, members, and employees. With a presence in communities across the country, CVS Health colleagues are and will continue to be a critical piece of the country’s health care solution. The health and safety of our employees, patients, customers, and members is our top priority as we face the impact of COVID-19 together. If you would like to learn about the actions we are taking as a company as we learn more about COVID-19 and its spread, we encourage you to visit our COVID-19 resource center at https://cvshealth.com/covid-19
We offer a diverse work experience that empowers colleagues for career success. In addition to skill and experience, we also seek to... attract and retain colleagues whose beliefs and behaviors are in alignment with our core values of collaboration, innovation, caring, integrity and accountability.
CVS Health is an equal opportunity/affirmative action employer. Gender/Ethnicity/Disability/Protected Veteran – we highly value and are committed to all forms of diversity in the workplace. 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. We comply with the laws and regulations set forth in the following EEO is the Law Poster: EEO IS THE LAW and EEO IS THE LAW SUPPLEMENT. Please note that we only accept applications for employment via this site.
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