Chief of Staff - R&D
Addepar$143,000 - $224,000/year
Full Time
Expert & Leadership (9+ years)
Executive Director, Medicare Part D Strategy at CVS Health
Hartford, Connecticut, United States
Not SpecifiedCompensation
Senior (5 to 8 years), Expert & Leadership (9+ years)Experience Level
Full TimeJob Type
UnknownVisa
Healthcare, InsuranceIndustries
Requirements
- 12+ years of progressive experience in Medicare, pharmacy, or healthcare strategy, with at least 5+ years specifically focused on Medicare Part D
- Demonstrated expertise in CMS Part D bid process, financial reconciliation, and regulatory requirements
- Experience leading strategy for both MA-PD and PDP lines of business
- Track record of driving innovation in Part D product or pricing strategy
- Knowledge of Inflation Reduction Act (IRA)
- Strong understanding of PBM contracting, formulary economics, rebates, and drug pipeline monitoring
Responsibilities
- Develop and refine enterprise Part D strategy across MA-PD and PDP products, balancing growth, profitability, and regulatory compliance
- Partner with Product, Actuarial, and Finance teams to translate enterprise objectives into actionable Part D strategies (e.g., formulary, benefit design, premium positioning, IRA drug price negotiations)
- Anticipate regulatory and competitive developments (e.g., CMS Part D redesign, IRA provisions, PBM reforms) and proactively recommend strategic responses
- Serve as a thought leader on market trends in drug pricing, specialty pharmacy, rebates, and value-based pharmacy contracting
- Work alongside Medicare and Enterprise leadership to ensure Part D strategy integrates with overall Medicare Advantage and Medicare Supplement objectives
- Collaborate with Actuarial and Finance on bid strategy, forecasting, and sensitivity analyses, ensuring alignment with enterprise risk and margin targets
- Partner with PBM, Clinical, Trade, and Pharmacy teams to evaluate formulary options, rebate strategies, utilization management, and site-of-care optimization programs
- Coordinate with Stars, Risk Adjustment, and Network teams to capture cross-functional impacts on Part D performance
- Define and monitor KPIs for Part D performance, including membership growth, formulary competitiveness, net drug costs, rebate yield, PBM fees, and CMS settlement outcomes
- Lead development of scenario analyses for formulary and pricing strategy, including IRA negotiation impacts, pipeline monitoring, and generic/biosimilar entry
- Provide executive-ready presentations and decision materials for senior leadership and the Board on Part D performance and strategy
- Engage with CMS, PBMs, and industry forums to represent the organization’s perspective on Part D policy and regulatory change
- Build relationships with pharmaceutical manufacturers to inform pipeline monitoring and negotiation strategies
- Serve as an internal and external subject matter expert on Part D policy, economics, and strategic direction
Skills
Medicare Part D
CMS rules
bid processes
PBM contracting
formulary economics
drug pricing
Medicare Advantage
PDP
actuarial analysis
benefit design
regulatory compliance
IRA provisions
specialty pharmacy
rebates
value-based contracting
CVS Health
Comprehensive pharmacy and healthcare services
About CVS Health
CVS Health operates a large network of retail pharmacies and walk-in medical clinics across the United States, providing a variety of health-related products and services. Their offerings include prescription medications, over-the-counter health products, and beauty items, as well as pharmacy benefits management and specialty pharmacy services. CVS Health's integrated business model allows them to serve individual consumers, businesses, and communities effectively, with a focus on improving health outcomes and reducing healthcare costs. Unlike many competitors, CVS Health combines pharmacy services with medical care, making it easier for patients to access quality healthcare. The company's goal is to enhance access to healthcare and support individuals in achieving better health.
Woonsocket, Rhode IslandHeadquarters
1963Year Founded
DEBTCompany Stage
Healthcare, Consumer GoodsIndustries
10,001+Employees