• Dedicated role responsible for advancing strategic business relationships within the Aetna Medicare segment on behalf of the Aetna Integrated Pharmacy Unit.
• Responsible for managing contractual relationship and service delivery on behalf of Pharmacy Services Segment in support of Medicare segment
• Help negotiate pricing and financial structure of intercompany agreement including approach to transfer pricing for delegated services
• Lead and direct the activities of sales and account team by providing overall direction and strategy.
• Develop and execute long term strategic account plan working in close partnership with Aetna Medicare business
• Communicate and champion Aetna’s vision within the Caremark organization while maintaining the confidential nature of product specific strategies.
• Responsible for overall services agreement management, ensuring that the organization is aligned with unique requirements as well as avoidance of service level risks.
• Ensure increased enterprise revenue/profit through effective positioning of Caremark products and services based on market or regulatory dynamics affecting each line of business.
• Assist staff with strategic activities, utilizing account planning and other tools.
• Develop strong relationships within the organization, work effectively with internal department leadership, and create awareness of developments with senior leaders when appropriate.
• Identify and communicate market trends to staff and Aetna colleagues while positively positioning CVS Health pharmacy services.
• While maintaining a focus on the customer, identify and work as an agent of change internally.
• Develop and challenge staff to realize their highest potential.
• Deliver on revenue and operating margin targets while retaining customers and exercising upsell opportunities.
• Lead projects to improve Caremark’s delivery of innovative products by providing the client and specific market perspective.
• Foster and maintain relationships with senior level individuals in the Aetna Government Services division.
• Develop and execute membership retention and growth strategies.
• Deliver, interpret and educate staff on financial and clinical reports in preparation of quarterly and annual Aetna business unit performance reviews.
• Candidates should possess the experience, credibility and demeanor to interact with individuals at the highest levels within large, complex health plan accounts.
• Has knowledge of regulated managed care products and services, including knowledge of applications, limitations, and financial options.
• Good understanding of key sales competencies required to support the sales process
• Act as the business owner for implementation of solutions and products for each line of business.
• Act as the business lead for the timely delivery of pricing and other CMS application and bid requirements to Aetna Medicare with regard to the differences for each line of business. (PDP, Group, MAPD, MA-Only, DSNP, VBID).
• Oversee and report out on the annual enrollment and welcome season activities including meeting with project teams and work stream leaders to identify risks, issues, and contingency plans.
10+ years of experience in a PBM sales/service executive role with strategic account and leadership experience. 5+ year of experience in government regulated products, experience with CMS bid process is also a plus. Energetic, focused and willing to think creatively. Proven performance in a PBM sales/service position.
COVID-19 Vaccination Requirement
CVS Health requires its Colleagues in certain positions 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, pregnancy, or religious belief that prevents them from being vaccinated.
If you are 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 within the first 10 days of your employment. For the two COVID-19 shot regimen, you will be required to provide proof of your second COVID-19 shot within the first 45 days of your employment. Failure to provide timely proof of your COVID-19 vaccination status will result in the termination of your employment with CVS Health.
If you are unable to be fully vaccinated due to disability, medical condition, pregnancy, or religious belief, you will be required to apply for a reasonable accommodation within the first 10 days of your employment in order to remain employed with CVS Health. As a part of this process, you will be required to provide information or documentation about the reason you cannot be vaccinated. If your request for an accommodation is not approved, then your employment may be terminated.
1. Progressively responsible experience in sales and/or marketing with a major healthcare provider health services or consulting firm doing business with managed care.
2. Strong understanding of operations and sales, with ability to solve complex problems through people in other functional organizations, such as IT, Operations, Sales, and others.
3. Outstanding client communication savvy and willingness to engage in critical conversations.
4. Demonstrated Action/Problem solving orientation
Bachelor’s degree required. MBA preferred.
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.