AVP, Business Operations - Medical Policy & Program Solutions

$157,800 - $363,936/Yr

CVS Health - Phoenix, AZ

Full-time - Senior

Remote - Phoenix, AZ

Health and Personal Care Retailers

About the position

The AVP, Business Operations for Medical Policy & Program Solutions at CVS Health is responsible for developing and executing strategic and operational objectives across Commercial, Medicare, and Medicaid lines of business. This role focuses on achieving financial and performance targets while managing key vendor relationships and ensuring operational efficiencies that lead to significant cost savings for the enterprise.

Responsibilities

• Lead the strategy and drive operational efficiencies across Commercial, Medicare, and Medicaid lines of business.
• Manage the primary relationship with key vendors and oversee the contractual process.
• Execute short and long term strategic and operational objectives for Commercial, Medicare, and Medicaid lines of business.
• Collaborate with executive leadership and serve as the primary representative of the business in vendor meetings.
• Achieve cost savings through successful implementation and management of Scoreable Action Items (SAIs).
• Develop and maintain collaborative relationships with internal and external partners.
• Lead a team to promote high standards of operational practice and align clinical and non-clinical processes.
• Implement and monitor operational processes and workflows using industry best practices.
• Develop staffing models that are consistent, cost-effective, and compliant.
• Lead, develop, and manage high-performing teams to meet organizational goals.
• Foster a culture that supports professional development and operational excellence.
• Support CVS Health in attracting and retaining a diverse workforce.

Requirements

• 15+ years of experience leading complex teams in the healthcare system including medical management, claims, and provider networks.
• Strong interpersonal and communication skills to effectively communicate with executive leaders and stakeholders.
• Strong business and financial acumen with a history of achieving results.
• Expertise in operationalizing vendor solutions to complex issues.
• Ability to develop innovative operational changes and demonstrate executive presence.
• Ability to work in a hybrid model and travel up to 20%.

Nice-to-haves

• Experience in managing vendor relationships and contracts.
• Knowledge of healthcare regulations and compliance requirements.

Benefits

• Full range of medical, dental, and vision benefits.
• 401(k) retirement savings plan with company match.
• Employee Stock Purchase Plan.
• Fully-paid term life insurance.
• Short-term and long-term disability benefits.
• Well-being programs and education assistance.
• Free development courses.
• CVS store discount and partner discount programs.
• Paid Time Off (PTO) and paid holidays.