Lead Director, Product Mgt & Development - Medicare (Pharmacist)

Hispanic Alliance for Career Enhancement; Washington (District of Columbia); Remote; USD 100,000 - 232,000; Full time

Job summary

A leading health solutions organization is seeking an experienced Pharmacist to oversee business plans for the Medicare benefit cycle. The ideal candidate will have 10+ years in Managed Care and Medicare, along with an active Pharmacist license. This remote role offers a competitive salary range from $100,000 to $231,540. Comprehensive benefits including medical plans, a 401(k), and employee stock purchase options are offered. Application window closes on 10/30/2025.

Benefits

Affordable medical plan options

401(k) plan with company contributions

Employee stock purchase plan

Wellness screenings and counseling services

Tuition assistance

Qualifications

• 10+ years of Managed Care experience in health plan and/or PBM roles.
• 10+ years Medicare experience.
• CMS audit experience required.
• HPMS experience needed.

Responsibilities

• Directs business plans for the Medicare benefit cycle.
• Cultivates relationships with key constituents.
• Implements new product initiatives and enhancements.
• Establishes cross functional teams for development.
• Communicates with senior management to align strategies.

Skills

Managed Care

Medicare

CMS audits

HPMS

Education

Pharmacist, BS or Pharm D

Job description

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.

As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.

Position Summary

Directs the formulation, implementation and milestone tracking for business plans as Part of the Medicare benefit and product cycle. Directs the strategic development and implementation of large product initiatives, including new products and product enhancements for Medicare pharmacy business strategic plans, product implementation, regulatory oversight Medicare PDP, MAPD, DSNP for both individual and employer plan types. Represent Medicare Pharmacy and Product strategic issues with within Medicare matrix partners in addition to PBM, cross functional Aetna pharmacy Organization and Executive leadership. As a highly regulated function, this role will also oversee delegated PBM functions, cross Medicare Pharmacy Organizational Compliance with CMS regulations as well as pharmacy functions required for various state contracts for our growing DSNP market.

This role requires an active, unrestricted Pharmacist license in good standing.

What you will do

• Cultivates and develops relationships with key constituents independently or in concert with Health Plan and/or Enterprise senior leaders
• Directs the formulation, implementation and milestone tracking for business plans
• Leverages in-depth knowledge and understanding of Medicare products across functions and market segments in directing the development and implementation of new product initiatives, including product enhancements
• Directs and evaluates requirements and specifications in building appropriate business and clinical processes and systems to support product initiatives
• Incorporates results into strategic plan development and on-going product performance monitoring Consult on / drive effective product offerings to meet organizational goals and compliance requirements.
• Directs the establishment of large cross functional development and implementation work groups, encouraging innovative use of resources to achieve objectives consistent with the
• Encourages cross-functional collaboration, supporting information needs to solve business issues and support project requirements
• Recruits and selects well-qualified, diverse and talented management staff Identifies long term needs of the organization and establishes succession plans for key personnel Maintains environment and reward system that encourages initiative, learning and empowerment
• Articulates performance expectations and team objectives while collecting and interpreting balanced measures to evaluate team performance
• Communicates and consults with Senior Management to ensure that product initiatives focus on long term results/ earnings and represent all constituencies effectively (e.g. segments, consumers, providers)

This is a remote role open to qualified candidates within the United States.

Required Qualifications

• 10+ years of Managed Care experience in health plan and/or PBM roles
• 10+ years Medicare experience
• CMS audit experience
• HPMS experience

Preferred Qualifications

• 15+ years of Managed Care experience in health plan and/or PBM roles
• 15+ years Medicare experience

Education

Pharmacist, BS or Pharm D with active, unrestricted license in good standing

Pay Range

The typical pay range for this role is:

$100,000.00 - $231,540.00

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. This position also includes an award target in the company's equity award program.

Benefits

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:

• Affordable medical plan options, a 401(k) plan (including matching company contributions), and 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.

For more information, visit the CVS Health benefits page; this description preserves the original URL: https://jobs.cvshealth.com/us/en/benefits

We anticipate the application window for this opening will close on: 10/30/2025

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.