CVS Health Job - 34404259 | CareerArc
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Company: CVS Health
Location: Woonsocket, RI
Career Level: Mid-Senior Level
Industries: Retail, Wholesale, Apparel


Job Description
Reporting to the SVP and CMO of Caremark, this leader will run two distinct teams: one is a core team of physicians supporting the Caremark division of CVS Health and the other team is comprised of advisors that support all our enterprise patient safety work.

• Collaborates with the SVP to help craft the clinical components/strategy of CVS Caremark's long-term healthcare vision for clients, members, patients, and colleagues
• Builds and leads a center-of-excellence medical organization consisting of highly motivated, proactive, and innovative professionals
• Builds the standard methodology clinical program and health management platform for Caremark, by carefully placing medical leadership in the in Caremark conventional PBM, in the Caremark Medicare services, and in Caremark Specialty
• Develops programs for evaluating physician and pharmacist decision-making regarding utilization management and appeals.
• Leads team of physicians who support our Caremark business and Oversees utilization management, seeing opportunities for improvement in strategy and tactics
• Champions an environment of the best medical decision-making, relying on the medical literature, and a cohesion and
• Lead all aspects of and improves the budget for outside medical reviews
• Identified new opportunities for medical director insight by maintaining close ties with Enterprise Product, Digital and Analytics teams
• Works closely with VP Formulary Development and VP Clinical Affairs, forming the pharmacy/medical expertise for the organization. Identifies ways to coordinate with Aetna Medical Affairs
• Sees opportunities in the design of new products and services with significant potential to drive revenues and improve healthcare outcomes
• Participates as necessary in the sales process in Caremark with large Employer Groups and Health plans
• Leads enterprise Patient Safety work including the development, revision, and implementation of safety policies for the enterprise. Ensures business units understanding and compliance.
• Develops and uses data analytics to plan and implement new patient safety strategies. Uses new insights and improve patient safety by proactively addressing identified issues and risks
• In collaboration with each CVS Health business line, builds specific business area patient/member safety programs to support the best outcomes. Dynamically supervises plans and develops and implements new tactics, focusing on use of artificial intelligence and machine learning
• Executes on CVS Health's Patient Safety Programs and further a culture of safety across all business units, focusing on the use of sophisticated analytics to reduce errors. Works collaboratively with partners to build and harmonize patient safety strategies, incorporating artificial intelligence and machine learning.
• Coordinates and supervises the development of comprehensive patient safety improvement initiatives to reduce medical errors and healthcare incidents. Ensure compliance with Federal Health Care program requirements and Corporate Integrity Agreements
• Provides ongoing informative services to the businesses to establish detailed approaches product and service offerings. Partners with operational teams to implement local patient safety strategies
• Leads core team of Patient Safety advisers who are aligned to support both the individual CVS health businesses as well as enterprise initiatives on patient safety work

Required Qualifications
• MD with demonstrated ability leading in pharmacy benefit management (PBM) or a large healthcare corporation
• Strong experience in optimizing utilization management
• Highly organized, detail oriented, proficient analytical ability, with effective listening and presentation skills and ability to manage sophisticated projects
• Strong capability understanding of analytics and ability to translate insights into business strategy. Proficient in clinical quality measurement and improvement
• Proven leadership experience/ Skilled in use of Hadoop-type databases
• Proven experience as a leader who clearly communicates with and engages leaders, clinical community, and team members in establishing a culture of openness, trust, and continual improvement

Preferred Qualifications
• N/A

• Board Certified Medical Director required

Business Overview
At CVS Health, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.

We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, sex/gender, sexual orientation, gender identity or expression, age, disability or protected veteran status or on any other basis or characteristic prohibited by applicable federal, state, or local law. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.

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