Job Description

Job Description
The Director of Formulary Management System and Pharmacy Operations is responsible for ensuring achievement of strategic goals through the design and implementation of clinical requirements, CVS template and Client custom, leveraging Formulary Management system and clinical design principles.
You will be leading the requirements and design of a new product called Formulary Management system, partnering with IT, which will enable internal users and clients to define their formulary requirements and tier structure, and utilization management rules. In addition, develop features within Formulary Management system to include formulary search tool for members and clients, publication of the formulary and UM as well as CMS submission of Medicare formularies and UM.
Your team will be responsible for defining business requirements for the Formulary Management system product, perform user acceptance testing prior to product release and support end users. In addition, You will be responsible for defining the strategy and migration plan of clients on to Formulary Management system platform. Coordinate with Rebates team to ensure they receive accurate and timely data from Formulary Management System such that Rebate invoices can be submitted in a timely manner. Coordinate with other teams to align the vision and strategy of Formulary Management system to enhance the business value and expand the usability of the product.
Clinical Operations responsibilities includes achievement of strategic goals through the design and implementation of client pharmacy benefits requirements in CVS Healths business rules/adjudication system leveraging Formulary Management system; formularies, clinical and rebate programs.
You will be leading the product development team and clinical operations pharmacist team, and will have a team of approximately 10-20 full time clinical specialists, and 10-15 contractors. You will also be accountable for managing the financial budget for your team along with achieving service warranties and performance guarantees targets. Some of your key responsibilities will include:
-Lead product development of Formulary Management system by providing timely business requirements that aligns to the product strategy and roadmap
- Implement clients on Formulary Management system platform
- Coordinate with Training on user training and adoption
- Support end users with product related issues, leveraging IT partners as needed
- Defining strategies to improve the implementation and maintenance of plan clinical benefits for our health plan clients
- Building a high-performing team by providing opportunities, guidance and feedback to develop colleagues and ensure a pipeline of talent for future growth
- Ensure your teams critical metrics and strategic projects are achieved
- Initiate and implement quality improvement for the department

Required Qualifications
* 8+ years leading product development teams leveraging technology driven solutions
* 6+ years of experience leading operations and/or service delivery
* 5+ years of client facing, management experience
* 5+ years of demonstrated direct people leadership experience, managing teams across multiple locations and functions
* 5+ years of experience working with IT projects methodologies and processes
* Willingness and ability to travel up to 25-40%

Preferred Qualifications
* Pharmacy Benefits Management (PBM) experience with RxClaim experience
* Consulting, Project Management and/or Implementation Experience
* Experience developing, measuring, monitoring, and driving improvement in New Client Implementations Key Performance Indicators
* Solid understanding and experience with healthcare products including formulary, utilization management and accumulations

Education
* Bachelors degree in computer science or equivalent Engineering background
* Equivalent Combination of experience and education may be considered

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.