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Vice President, CFO, PBM Underwriting & Analytics

https://www.cvshealth.com/ Logo

CVS Health

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Location:
United States , Woonsocket, Rhode Island

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Category:
Finance

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Contract Type:
Not provided

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Salary:

275000.00 - 375000.00 USD / Year
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Job Description:

We are seeking a dynamic and experienced executive to serve as Vice President, Head of Underwriting for Caremark’s Health Plan Segment. This role will lead the client pricing, underwriting, analytics, RFP pricing, and client profitability functions for current and prospective PBM health plan clients, including specialty‑only clients, rebate‑only clients, medical rebates, and home infusion. This is a senior financial leadership role, accountable for profitability, margin performance, and long‑term economic sustainability for a large portfolio. The leader will own client‑level financial outcomes, balancing growth, retention, competitiveness, and profitability across the full client lifecycle.

Job Responsibility:

  • Lead and manage an organization of approximately 90 colleagues across underwriting, client pricing, RFP pricing, analytics, and client profitability management
  • Establish and execute the underwriting and client profitability strategy aligned to enterprise objectives and segment financial targets
  • Drive a culture of financial accountability, disciplined decision-making, collaboration, and continuous improvement
  • Partner with senior leadership to define and monitor KPIs that measure pricing effectiveness, profitability, and long-term client value
  • Oversee the end-to-end underwriting and pricing process for PBM health plan clients, including 250+ pricing events annually across new business, renewals, and mid-term actions
  • Maintain direct accountability for RFP pricing strategy and execution, ensuring competitive, accurate, and profitable pricing outcomes
  • Ensure alignment across pricing offers, negotiations, and contracting with a clear focus on financial risk management and margin protection
  • Continuously review and refine underwriting and pricing processes to improve accuracy, efficiency, and scalability
  • Monitor market trends, competitor dynamics, and regulatory developments to inform underwriting and pricing strategy
  • Interact extensively with executive leadership to align on pricing positions, concessions, and overall underwriting approach
  • Own responsibility for achieving segment-level revenue and margin objectives through disciplined underwriting and active management of client economics
  • Develop and execute multi-year financial plans to optimize near- and long-term performance
  • Make informed decisions that balance client retention, growth opportunities, and profitability
  • Ensure strong linkage between underwriting assumptions, pricing decisions, and realized financial performance over time
  • Drive delivery of advanced analytics and consultative insights to support client financial performance and pharmacy trend management
  • Leverage data to identify financial risks, opportunities, and emerging trends at both the client and segment level
  • Translate complex financial and utilization data into clear, actionable insights for internal leaders, clients, and consultants
  • Partner with IT and data science teams to enhance analytical tools, financial models, and data infrastructure
  • Serve as a senior leader engaging directly with health plan clients, participating in financial deep dives when detailed discussion of pricing, profitability, or performance is required
  • Build and maintain strong relationships with external stakeholders, including clients and consultants, serving as a trusted underwriting and financial expert
  • Build strong internal partnerships across Client Services, Sales, Proposals, Supply Chain, Legal, Regulatory, Finance, Clinical, and Product teams
  • Act as a subject matter expert on PBM underwriting and client profitability, representing the organization externally as appropriate
  • Mentor and develop leaders
  • Foster a culture of continuous learning, high engagement, and performance in a fast-paced, high-stress, high-visibility environment
  • Make talent development and succession planning a priority to maintain an industry-leading organization

Requirements:

  • Approximately 15 years of healthcare experience, with deep PBM expertise, including client pricing and underwriting
  • Demonstrated success owning client-level financial outcomes, including profitability, margin performance, or equivalent accountability
  • Extensive understanding of the PBM landscape, health plans, and multiple lines of business with varying funding arrangements
  • Must be comfortable meeting with clients
  • Proven success partnering successful in a complex matrixed organizations
  • Strong executive communication skills with the ability to influence internal leadership and engage directly with health plan clients
  • In-depth knowledge of PBM operations, market dynamics, and regulatory environment
  • Ability to operate independently, manage competing priorities, and delegate effectively
  • Proven experience developing teams
  • Remote role with up to 25% travel
  • Bachelor’s degree required
  • MBA valued
What we offer:
  • Affordable medical plan options
  • a 401(k) plan (including matching company contributions)
  • 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

Additional Information:

Job Posted:
March 03, 2026

Expiration:
March 09, 2026

Employment Type:
Fulltime
Work Type:
Remote work
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