Executive Director, Clinical Services Operations - PBM

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary CVS Caremark is the nation's leading pharmacy benefit manager (PBM). We work to ensure the path to better health is affordable, easy to access, and simple to follow, for our 103 million plan members. We provide personalized support to help people start and stay on their medications, because people who take their medications have better outcomes and lower health care costs. CVS Caremark is recruiting for an Executive Director, Clinical Services Operations for the PBM Client Services and Support teams. This transformational leader is responsible for providing strategic leadership over Prior Authorization (PA) Administration across three platforms, PA Client Liaisons, Clinical Implementation for Non-Adjudication Programs, Business Innovation and Intelligence, Service Warranty and Performance Guarantee Management. As PBM delivery and client needs evolve, this leader will architect and deliver scalable, value-driven solutions that support client needs and compliance with regulatory and accreditation standards while sustaining growth, operational excellence, and best-in-class clinical outcomes. The Executive Director is accountable for annual operating expense of $43M, oversees a Performance Guarantee budget of $600K, and a Service Warranty budget of $1.7 against a large risk portfolio. The PA Administration team is responsible for the oversight and delivery of end-to-end client configuration and fulfillment delivery to enable prior authorization delivery. The team oversees >300 implementations and 10,000 maintenance cas...