Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at its center - our purpose sends a personal message that how we deliver our services is just as important as what we deliver.
Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.Aetna is seeking a Director of Network Pharmacy to lead Strategy and Performance management across all lines of businesses. This role ensures that Aetna's pharmacy network operates efficiently, meets regulatory requirements, and delivers high-quality, cost-effective pharmacy services to members. In close partnership with Caremark, the Aetna Director of Network Pharmacy will ensure optimized access points for our products and members and negotiate agreements with retail and independent pharmacies to ensure performance, including value-based agreements.Major Responsibilities:
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- Develop and maintain relationships with Caremark and pharmacies.
- Negotiate contracts and agreements with retail and independent pharmacies, including intercompany arrangements.
- Ensure network compliance with federal, state, and local regulations.
- Develop and implement strategies to optimize the pharmacy network supporting key product and line of business strategic objectives.
- Analyze market trends and adjust network strategies accordingly.
- Monitor pharmacy performance and ensure adherence to quality standards.
- Implement quality improvement initiatives to enhance service delivery.
- Oversee budget planning and financial performance of the pharmacy network.
- Identify cost-saving opportunities while maintaining service quality.
- Work closely with cross-functional teams to align network strategies with organizational goals.
- Serve as a liaison between Aetna, Caremark, and pharmacy partners.
- Analyze risk, flags, and trends to mitigate fraud, waste, and abuse within the pharmacy network.
- Manage selection risk for pharmacies allowed in the network.
- Drive clinical and cost interventions for medical and specialty pharmacy by leveraging data and analytics to make informed recommendations.
- Minimum of 7 years of experience in pharmacy management or related experience, preferably in a leadership role.
- Proven experience in negotiating contracts and managing pharmacy networks.
- Strong leadership and communication skills.
- In-depth knowledge of pharmacy regulations and compliance.
- Ability to analyze data and make strategic decisions.
- Additional qualifications in healthcare management or business administration are advantageous.
- Experience with Medicare.
- Experience in identifying and preventing fraud, waste, and abuse in pharmacy services.
- Bachelor's degree preferred or combination of professional work experience and education.
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.
In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company's 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off ("PTO") or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.
For more detailed information on available benefits, please visit Benefits | CVS HealthWe anticipate the application window for this opening will close on: 03/29/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.