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Director, Medical Benefits Product

at CVS Health

Posted: 5/23/2020
Job Reference #: 1160837BR
Keywords: benefits

Job Description

Job Description
The Director - Medical Benefits Product will be responsible for driving growth in Specialty by 1) building innovative products that secure our position as the market leader in payor focused Specialty solutions and 2) creating disruptive and holistic solutions to support payor clients in their objectives of managing cost, utilization and quality for complex and high cost patients managed through the Medical benefits. Leader will be responsible for developing a robust product roadmap based on current and anticipated market trends, and working across the organization to deliver new and market leading solutions to market.


- Collaborate across organization - Product, Finance, Trade, Clinical Legal, Sales, Marketing - to develop innovative strategies that provide winning solutions to manage high cost therapies in market and in pipeline

- Build and execute medical benefits product roadmap that solves payor, provider and patient needs, including but not limited to:
- Medical formulary and coverage strategies (in partnership with Formulary Product, Clinical, Trade and other key stakeholders)
- Innovative utilization management approaches and operational processes to support
- Provider education and incentive strategies
- Roadmap to expand our suite of services beyond specialty pharmacy - e.g., medical UM


Thinks and Acts Strategically
- Identifies new innovation and sources of value for the enterprise and sets the pace for delivering results
- Creates and strengthens partnerships within and outside the enterprise to deliver new solutions
- Uses critical thinking and strategy to balance multiple stakeholder needs (e.g., patient, payor, pharma, pharmacy, enterprise)

Sets Direction
- Engages in business plan development and proactively anticipate needs that can be addressed with an innovation strategy or solution
- Builds the roadmap to deliver innovation by leading developing, validating, and scaling data driven solutions to maintain market leadership with patient experience, clinical outcomes, and cost management strategies
- Applies advanced knowledge and expertise to advance clinical, patient experience, and cost management strategies

Impacts and Influences
- Develops and maintains productive relationships with all levels
- Builds, develops, and inspires teams to deliver the roadmap for specialty innovation
- Represent specialty innovation, adherence, and digital messaging across the enterprise
- Apply clinical, contract, & performance guarantee thought leadership to gain new & retain existing business

Deep industry expertise of current and future specialty health care needs with proven ability to convert expertise into products and services
- Uses deep knowledge of specialty and overall health care market dynamics to deliver results
- Maintains deep understanding across the enterprise to efficiently and effectively drive innovation
- Develops, leads, and articulates the innovation story internally and externally to clients

Delivers results
- Plans, develops, and executes short- and long-range innovation, adherence, and digital messaging program goals
- Identifies risk and mitigation strategies to ensure deliver innovation solutions
- Prepares and delivers presentations that translate analytic insights to tangible actionable solutions to implement
- Sets vision and gains alignment from team and cross functional partners; holds individuals and self accountable for results.

This position can be located in a CVS Corporate Hub or has the ability to work remotely/work from home within the U.S

Required Qualifications
5 years plus experience in medical benefits management and in-depth understanding of marketplace dynamics to anticipate and address emerging market needs

Active Pharmacist license that is in good standing

Ability to manage and direct a team responsible for developing, building and managing end to end solutions

Ability to frame complex problems and develop solutions that address multiple interests with minimal guidance and direction - trusted team member with considerable autonomy to shape strategic direction of offerings.

Advanced Impact and Influence skills - ability to influence and establish rapport with colleagues both senior and junior to him/her.

Exemplary leadership and management skills.

Superb communication and presentation skills.

Experience working effectively with multiple other teams and driving work forward in a matrix-style organization.

Ability to achieve established goals while navigating a complex and highly matrix structured organization.

Deep analytical abilities - design business plans and find insights through analytics and to make recommendations for innovation strategy and refinement.

Ability to travel 1-2x per month.

Build and rationalize funding and resource proposals

Preferred Qualifications
5+ years health plan, managed care, product development

- Bachelor of Science in Pharmacy required
- Doctor of Pharmacy (Pharm.D.) preferred
- MBA preferred

Business Overview
It’s a new day in health care.

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
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.

We provide reasonable accommodations to qualified individuals with disabilities. If you need to request an accommodation, a qualified interpreter, written information in other formats, translation or other services, please contact our Advice and Counsel Reasonable Accommodations team by emailing Advice and Counsel Reasonable Accommodations team or calling 877-805-9511.

If technical issues are preventing you from applying to a position, contact Kenexa Helpdesk at 1-855-338-5609 or For technical issues with the Virtual Job Tryout, contact the Modern Hire Help Desk at 1-877-451-1695 or

Application Instructions

Please click on the link below to apply for this position. A new window will open and direct you to apply at our corporate careers page. We look forward to hearing from you!