Avp, Pharmacy Operations & Strategy Job at CVS Health (Hartford)

Job Description

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. The AVP, Aetna Pharmacy will provide day-to‑day leadership, operational oversight, and strategic execution across Aetna Pharmacy’s portfolio. This includes direct responsibility of all pharmacy functions across the Medicare, Medicaid, and Commercial lines of business and Aetna Pharmacy Strategy & Operations. This leader will translate enterprise pharmacy strategy into actionable plans, manage operational performance, and ensure strong alignment and partnership with the IBU/PBM, Aetna business segments, Enterprise Pricing, and clinical and product partners. Working closely with the VP, Aetna Pharmacy and Value Management, the AVP will drive execution on our critical priorities: optimize pharmacy and medical pharmacy total cost of care, deliver a seamless member/provider experience, accelerate operational excellence, and collaborate for enterprise growth.

Job Responsibility

Lead daily management of Aetna Pharmacy operations, performance oversight, and execution of strategic initiatives across all lines of business
Under direction of VP, develop and own a multi‑year pharmacy strategy, ensuring near‑term execution decisions, investments, and priorities are aligned to and advance long‑term affordability, experience, and growth objectives
Drive pharmacy performance outcomes including trend mitigation and clinical quality improvement in alignment to regulatory, contractual, and audit requirements
Partner with Aetna Medicare, Medicaid, and Commercial leadership to: Align pharmacy goals and KPIs to line of business strategies, Support benefit design, formulary execution, pipeline monitoring, Stars pharmacy measures, and service delivery, Coordinate performance reviews, trend analysis, operational updates, and improvement plans across each business
Serve as primary day-to‑day liaison with enterprise partners (e.g., IBU/PBM, CVS Specialty, and Retail) to ensure best-in‑class pharmacy capabilities, timely operational support, and operational issues are triaged and resolved quickly
Facilitate ongoing activities related to rebate forecasting, formulary execution, adherence to guarantees, clinical programs, underwriting support, and product design inputs
Coordinate closely with Enterprise Pricing, Actuarial, Clinical, Product, and Service teams to ensure integrated execution and alignment
Lead operational components of Aetna’s pharmacy trend strategy, including analysis, reporting, and execution of trend‑mitigating SAIs and clinical interventions
Own pharmacy contributions to member and provider experience improvement, including simplification of utilization management workflows and reduction of administrative friction
Proactively identify risks, operational issues, and improvement opportunities, and drive process enhancements to improve timeliness, accuracy, and member and provider experience
Build, lead, and develop a diverse, high‑performing team with expertise in pharmacy operations, strategy, analytics, and cross‑functional execution
Foster a culture that values collaboration, accountability, operational rigor, and continuous improvement
Prepare materials and represent Aetna Pharmacy for VP+ level and executive updates including performance reports, strategic initiative updates, trend results, and financial/clinical outcomes

Requirements

12+ years of experience in health plan pharmacy, PBM, or related healthcare roles with progressive leadership and increasing operational responsibility
Deep understanding of health plan and PBM operational dynamics, including pharmacy financial drivers, clinical quality programs, and pharmacy benefit strategy with demonstrated ability to translate strategy into execution
Working knowledge of formulary strategy, rebate structures, and PBM economics, with experience applying these levers to drive performance outcomes
Solid knowledge of utilization management and the interplay between pharmacy and medical benefit dynamics with experience operationalizing programs at scale
Demonstrated ability to navigate complex stakeholder environments, including engaging with external clients and influencing senior internal stakeholders
Proven experience leading and influencing in a highly matrixed environment, partnering across enterprise stakeholders to drive alignment and decision-making, including managing up and driving decisions in complex organizational structures
Strong analytical capabilities, with the ability to interpret trend, financial, and operational data and translate insights into action and execution plans tied to measurable outcomes
Track record of driving performance improvement and managing multiple, concurrent initiatives at scale with clear accountability for results (e.g., cost of care, trend, quality, or experience)
Excellent interpersonal, communication, and relationship-building skills, with the ability to engage effectively across all levels of the organization including VP+ leadership

What we offer

Medical coverage
Dental coverage
Vision coverage
Paid time off
Retirement savings options
Wellness programs

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