Senior Manager, Project Management – Pharmacy Compliance

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CVS Health

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1963

🏥 Healthcare

⚕️ Healthcare Insurance

🛒 Retail

Healthcare • Healthcare Insurance • Retail

CVS Health is a leading American healthcare company dedicated to improving health access and affordability. The company focuses on a comprehensive approach that includes health services, health insurance, and pharmacy benefits management. Through its subsidiaries, such as Aetna and CVS Caremark, CVS Health offers a range of services that facilitate wellness, condition management, and affordable prescription drug coverage. CVS Health operates neighborhood pharmacies, provides mail-order pharmacy services, and manages specialty medication programs, aiming to make healthcare convenient and accessible for everyone. Driven by a mission to connect people with essential care services, CVS Health is committed to fostering healthier communities and supporting the wellbeing of all individuals.

📋 Description

• Lead strategic compliance initiatives and complex cross-functional projects impacting pharmacy programs and prescription drug products administered through the pharmacy and medical • Serve as a subject matter expert on legislation, regulatory requirements, and compliance initiatives • Provide regulatory interpretation, impact assessments, and implementation guidance • Oversee compliance activities and operational processes, including prior authorization and utilization management requirements for prescription drug products processed through the medical benefit • Partner with Pharmacy, Medical Pharmacy, PBM, Legal, Clinical, Operations, and business stakeholders to implement regulatory changes • Mitigate compliance risks and ensure business readiness • Support regulatory inquiries, audits, reporting, monitoring activities, and compliance governance efforts • Drive regulatory readiness, process improvement, and operational effectiveness across compliance programs • Mentor and develop project managers • Help shape compliance strategy and execution across the organization

🎯 Requirements

• 7+ years of experience in pharmacy benefit management, pharmacy operations, managed healthcare, compliance, regulatory affairs, or related healthcare functions • 5+ years of project management experience, including leadership of complex compliance or regulatory initiatives • Strong knowledge of healthcare regulatory environments and legislative review processes • Proven ability to lead cross-functional teams and manage multiple high-impact initiatives simultaneously • Strong analytical, problem-solving, and decision-making skills • Exceptional communication, collaboration, and stakeholder engagement skills • Proficiency in Microsoft Office Suite, including Excel, Outlook, PowerPoint, SharePoint, and Teams • Role can be located anywhere in the Mainland United States • Experience interpreting and implementing healthcare legislation and regulatory requirements • Knowledge of pharmacy benefit programs and prescription drug products administered through the medical benefit • Experience supporting compliance programs, regulatory implementation activities, prior authorization, utilization management, or related operational processes • Demonstrated ability to influence stakeholders and drive complex cross-functional initiatives in a highly matrixed environment • Experience mentoring, coaching, or leading project managers and project teams • Project Management Professional or other relevant project management certification is preferred

🏖️ Benefits

• CVS Health bonus, commission or short-term incentive program • Award target in the company’s equity award program • Medical coverage • Dental coverage • Vision coverage • Paid time off • Retirement savings options • Wellness programs • Other resources supporting physical, emotional, and financial well-being