AVP, Business Operations - Medical Policy & Program Solutions

$157,800 - $363,936/Yr

CVS Health - Hartford, CT

Full-time - Senior

Remote - Hartford, CT

Health and Personal Care Retailers

About the position

The AVP, Business Operations - 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 driving operational efficiencies. The position emphasizes collaboration with executive leadership and fostering a culture of diversity and inclusion within the organization.

Responsibilities

• Lead the strategy and drive operational efficiencies across Commercial, Medicare, and Medicaid lines of business.
• Manage the primary relationship with key vendors and ensure contract guidelines are met.
• 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 face of the business when meeting with key vendors.
• Achieve cost savings through successful SAI implementation and management.
• Develop and maintain collaborative relationships with internal and external partners, customers, and vendors.
• Lead a team that promotes high standards of operational practice through advancement of policies and procedures.
• Implement, monitor, and trend operational processes and workflows using industry best practices.
• Lead recruitment and operating model development to meet business needs.
• Oversee the implementation of staffing models that are cost-effective and compliant.
• Develop, motivate, and manage high-performing teams to meet organizational goals.
• Foster a culture that accelerates strategy through Heart At Work Behaviors.

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 external vendor solutions to complex operational issues.
• Established ability to develop innovative operational changes.
• Demonstrate executive presence and ability to interact with internal and external constituents.
• Ability to work a hybrid model and travel up to 20%.

Nice-to-haves

• Experience in managing vendor relationships in a healthcare setting.
• Knowledge of regulatory requirements in healthcare operations.

Benefits

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