Client Experience Manager, Pharmacy Benefits Management

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 Would you like to join CVS Health, a Fortune 5 company, on our multifaceted Pharmacy Benefits Management (PBM) Underwriting team? In this high-level individual contributor role, you will utilize your business, industry, competitive, client, and technical knowledge to formulate pricing strategy and to execute financial modeling of comprehensive pricing offers that include retail network, mail order, specialty, and pharmaceutical manufacturer rebates for PBM client contracts. Additional responsibilities to include but not limited to the following: Model and develop Truecost pricing proposals for Health Plan Clients Collaborating with PBM Sales and Account Services to provide recommendations on pricing and negotiation strategy to achieve revenue and profitability targets for new business growth and margin retention; and Applying advanced Excel modeling techniques to analyze large sets of pharmacy claims data and build forward looking financial forecasts and profit and loss (P&L) statements; and Presenting financial analyses to Executive Leadership during Executive Underwriting Approval Calls and responding to financial questions in real-time; and Supporting Underwriting Managers and Sr. Managers with ad-hoc financial analyses

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 Do you want to make a large impact in your next role? Join CVS Health as an Underwriting Sr. Analyst, where you will be responsible for Financial Analysis and Underwriting within the team. Here, you will work on key pricing activities to retain and grow pharmacy lives and support CVS Health and Finance leadership to drive value through network and formulary pricing strategies on multiple levels. In this high impact position, you will support key underwriting and financial analysis activities. This role will manage vast, complex Pharmacy Benefit Management (PBM) pricing strategies and pricing deployment designed to meet the business needs of the CVS Health Enterprise (PBM and Aetna as the client), and acts in an advisory capacity to the Aetna Underwriting team responsible for its downstream customers’ pricing. This position will report into the Sr. Manager of PBM Underwriting. The successful candidate will prioritize developing expert knowledge of the PBM and Health Plan Insurance industry economics and will have proven their ability to work on a high-performing team of knowledge-based employees with the necessary business acumen and technical skills to contribute to the goals of their team. The successful candidate will also have a track record of demonstrating the skill sets necessary to build a deep understanding of the client’s business and goals in order to suc

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 - Supports comprehensive coordination of Medicaid and/or Medicare pharmacy services including intake and processing of pharmacy authorization requests. - Promotes and supports quality effectiveness of healthcare and Pharmacy Services. - Evaluates, authorizes approval, and communicates decisions for pharmacy requests according to clinical guidelines. - Evaluates and authorizes approval of pharmacy requests received by telephone, facsimile, and/or other means using client clinical criteria. - Determines appropriateness for medications. Communicates decision to physicians, physician’s office staff, medical management staff, members, and/or pharmacists. - Will perform clinical research to support request. - Performs non-medical research including eligibility verification, COB, and benefits verification. - Maintains accurate and complete documentation of required information that meets risk management, regulatory, and accreditation requirements. - Process requests in compliance with various laws and CMS regulations and company policies and procedures. - May communicate with Aetna Case Managers, Health Plan Staff, External Pharmacies and Health Care Providers. - Promotes communication, both internally and externally, to enhance effectiveness of medication therapy management services. - Sedentary work involving significant periods of sitting, tal

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 This position would support one or more attorneys on the Pharmacy Benefit Management (PBM) contracting team. The job primarily involves working on legal contract documents, including drafting versions of documents from templates for attorney review, processing subsequent versions of documents with client or consultant revisions, incorporating comments and edits from internal partners, and assisting with intake, tracking, and administration of open contract files. Required Qualifications 2+ years of professional experience in a legal, contracts, administrative, business operations, project coordination, or similar environment. Strong organizational, time management, problem-solving, and communication skills. Ability to manage multiple priorities and work independently with appropriate guidance. Proficiency in Microsoft Word, including document formatting, tracked changes, comments, and document comparison functionality. Strong attention to detail and ability to work accurately with complex documents. Experience collaborating with cross-functional teams and stakeholders in a fast-paced environment. Preferred Qualifications Experience supporting contracts, legal documentation, compliance, procurement, business operations, or related functions. Experience working in a co

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 As a Senior Data Insights Specialist, you will be responsible for using SQL, MS Excel, Dataiku, Python, and related applications to determine disruption to existing and potential clients when network changes take place to retain and win business. This position involves making high-level decisions, managing multiple requests/priorities, developing new solutions to simplify the reporting process, and producing both standard and custom reports for multiple lines of business and specific clients regarding retail pharmacy network accessibility. Required Qualifications Experience in SQL, Microsoft Excel, and other relevant applications. Experience with data cleaning, transformation, and/or ETL. Strong analytical and problem-solving skills with the ability to interpret complex data sets. Preferred Qualifications 2&#43; years' of professional analytical experience. Proficiency in Dataiku, Alteryx, or other related ETL applications. Experience with Python. Experience with Salesforce. Working experience in the Pharmacy Benefits Management (PBM) or related healthcare industry. Excellent verbal and written communication skills to effectively interact with internal teams and external clients. Ability to manage multiple requests and priorities in a fast-paced environment.</li

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 The Strategic Account Executive (SAE) is responsible for the overall account strategy, renewal outcomes, and executive relationships for a defined portfolio of large, complex employer pharmacy benefit manager clients. This role is a senior individual contributor position. The SAE leads renewal strategy, guides financial decisions, and serves as a trusted partner to client and consultant stakeholders. The role focuses on judgment, clarity, and data‑informed decision‑making, not day to day service execution. Key Responsibilities Account Strategy & Executive Relationships Own the multi‑year account strategy for assigned clients. Serve as the primary executive‑level contact for client leadership. Help clients understand options, tradeoffs, and implications of complex pharmacy benefit decisions. Renewals, Retention & Growth Lead renewal strategy and negotiations , in partnership with underwriting, legal and finance. Develop and present clear recommendations on pricing, guarantees, and solution design. Identify growth opportunities through disciplined financial and strategic evaluation aligned to client goals. undefined Leverage analytics platforms and AI‑enabled tools to monitor performance and identify risks or opportunities</li