Senior Adjudication & Affordability Leader

CVS Health; Woonsocket (RI); On-site; USD 82,940 - 182,549; Full time

Benefits offered by this job

Medical, dental, and vision coverage

Paid time off

Retirement savings options

Wellness programs

Job summary

CVS Health is seeking a Senior Manager, Adjudication and Affordability to enhance prescription pricing and workflows across its ecosystem. This position focuses on cost-saving opportunities while collaborating with various departments to ensure compliance and improve patient experiences.

The ideal candidate will have 7-10 years of relevant experience, strong leadership skills, and a bachelor's degree or equivalent. Great benefits, including medical and retirement options, are offered to eligible employees.

Qualifications

• 7 to 10+ years of experience in adjudication, pharmacy operations, PBM operations, or healthcare technology.
• Proven ability to lead complex programs and influence partners without direct authority.
• Strong problem-solving skills with the ability to simplify complex topics.

Responsibilities

• Lead affordability strategies that reduce out‑of‑pocket costs and prescription abandonment.
• Design scalable and efficient prescription workflows.
• Serve as a subject matter expert for adjudication logic and benefits sequencing.

Skills

Leadership

Problem-solving

Communication Skills

Data Analysis

Education

Bachelor’s degree or equivalent pharmacy or operational experience

Tools

Excel

PowerPoint

Job description

CVS Health is seeking a Senior Manager, Adjudication and Affordability to enhance prescription pricing and workflows across its ecosystem. This position focuses on cost-saving opportunities while collaborating with various departments to ensure compliance and improve patient experiences.

The ideal candidate will have 7-10 years of relevant experience, strong leadership skills, and a bachelor's degree or equivalent. Great benefits, including medical and retirement options, are offered to eligible employees.