Senior Manager, Project Manager, Aetna Medicare Medical Pharmacy

Hispanic Alliance for Career Enhancement; Kansas; Hybrid; USD 67,000 - 200,000; Full time

Job summary

A leading health solutions company in the United States is seeking a Senior Manager for Aetna Medical Pharmacy. The role involves leading operations within the Medicare Part B Pharmacy Team and overseeing projects related to utilization management and clinical programs. Ideal candidates will have at least 5 years of experience in process and team leadership, coupled with a bachelor's degree. The company offers competitive salary range from $67,900 to $199,144 annually.

Qualifications

• 5 years of experience leading processes, products, and/or people.
• Experience managing complex processes that require strong attention to detail.
• Experience partnering with cross functional teams, PBM or Health Plan experience preferred.

Responsibilities

• Lead the day-to-day operations of key business projects and programs.
• Support the submission of pharmacy policies through multiple approval bodies.
• Develop processes and procedures for Medicare Part B program operations.

Skills

Leading processes

Attention to detail

Cross functional collaboration

Problem-solving

Growth mindset

Excel

PowerPoint

Word

Education

Bachelor's degree or equivalent experience

Tools

Excel

PowerPoint

Word

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.

As the Senior Manager, Aetna Medical Pharmacy, you will be accountable for leading the implementation of business projects and programs and managing operations within the Medicare Part B Pharmacy Team. You will act as a Subject Matter Expert impacting processes, systems, products, and/or functions. Responsible for overseeing and problem-solving daily operations issues within Medicare Part B. Partners with business owners to optimize the achievement of strategic business objectives, including profitable growth and improved organizational effectiveness.

Fundamental Job Components:

• Lead the day-to-day operations of key business projects and programs around utilization management (UM), clinical programs, and pharmacy operations.
• Proactively leads projects by setting direction, creating project plans, timelines, identifying key milestones, and allocating resources needed for selected projects.
• Support the submission of pharmacy policies through multiple approval bodies.
• Support the posting of pharmacy policies for internal and external partners and stakeholders.
• Develop processes, procedures, and systems to ensure consistent results and organizational compliance with regulations related to the organization's Medicare Part B program operations.
• Triage escalation requests to the correct internal partner and document resolution of Part B drug escalations.
• Identify gaps and recommend enhancements related to new and/or existing products, services, and workflows based on a broad view of the organization.
• Lead change initiatives and remains flexible to changing business needs, identifying and implementing continuous quality improvement.
• Conduct and lead meetings/presentations with cross-functional business partners ensuring team participation and collaboration.
• Clearly communicates plans for implementation to ensure all impacted parties (upstream/downstream) are informed of next steps for completion, facilitating team communication and coordination.
• Other duties as assigned.

Required Qualifications:

• 5 years of experience leading processes, products, and/or people
• Experience managing complex processes that require strong attention to detail
• Experience partnering with cross functional teams, PBM or Health Plan experience preferred
• Proven ability to collaborate effectively across teams and build strong relationships.
• Exceptional problem-solving and decision-making skills.
• Growth mindset with a focus on agility, continuous learning, and development.
• Proficient user of Excel, PowerPoint, Word

Preferred Qualifications:

• Project management certification.

Education:

• Bachelor's degree preferred or a combination of equivalent work experience and education.

The typical pay range for this role is: $67,900.00 - $199,144.00. 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.

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.

CVS Health is an equal opportunities employer. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.