Position Summary: The Product Management Director, Medication Therapy Management (MTM) role is a highly visible position within CVS Health. As the Director, you will be a strategic thought partner and responsible for developing the strategy, implementing and monitoring our MTM (Medication Therapy Management) program on behalf of our PBM clients. You will collaborate cross-functionally with other key stakeholders to drive health outcomes. In addition to MTM, you will be responsible for the monitoring, oversight and reporting for specific adherence programs.
Leading an experienced team of individuals, you will have responsibility over all aspects of the MTM program including oversight and management of a $40 million P & L, governance and oversight of our MTM Vendor, ensuring Centers of Medicare and Medicaid Services (CMS) regulatory compliance, managing client contracting and relationships as well as program pricing and strategic road map, client and internal reporting and analytics.
Additional responsibilities include:
*MTM Regulatory Compliance: Oversight over all Audit activities (internal, mock and CMS) as well as all CMS required reporting. Risk of non-compliance can lead to penalties, significant performance-guarantee payouts, Stars and quality measure ratings, reimbursement /payout impacts, and over all client dissatisfaction.
*MTM Product Management: For the 10 million beneficiary lives enrolled in the MTM program, provide oversight, governance and management of all operational aspects of the MTM program including completing over 260k Comprehensive Medication Reviews. Responsible for ensuring client and vendor inter-operability, rigorous monitoring of CMR activities, client engagement, pricing, contracting and stakeholder engagement. Additionally provide oversight of reporting, metrics and operational aspects of specific adherence programs.
*Innovate: Responsible for understanding market dynamics and strategies to ensure our MTM strategy is aligned with market needs and aligns to CMS vision. Director must be a strategic thought partner in this space
Required Qualifications: 1. Minimum of 8-10 years leadership experience in PBM, Health Plan, or Healthcare field required
2. Minimum 5-8 years experience in strategic planning and product management
3. Minimum 5-8 years experience executing against CMS and regulatory guidelines
4. Proven skills in strategic thinking and analytical skills, with the ability to diagnose complex problems and recommend practical solutions
5. Ability to work in a large organization and collaborate cross functionally with others regarding overall MTM strategy as well as vendor partners
6. Ability to lead and influence others and to effect change across organizational boundaries, particularly with large employers and health plans (PBM clients)
7. Leading and developing a high-performing team
8. Strong project management skills required, with the ability to communicate effectively with senior internal and external leadership
9. Quality ratings experience with Medicare and MA-PD plans a bonus
10. Driving development of key performance indicators to support business decision making
11. Complelling written and verbal communication skills
Preferred Qualifications: Knowledge and/or experience with MTM programs design and operations. Education:
Bachelor degree required; Advanced or Masters preferred.Business Overview:
CVS Health, through our unmatched breadth of service offerings, is transforming the delivery of health care services in the U.S. We are an innovative, fast-growing company guided by values that focus on teamwork, integrity and respect for our colleagues and customers. What are we looking for in our colleagues? We seek fresh ideas, new perspectives, a diversity of experiences, and a dedication to service that will help us better meet the needs of the many people and businesses that rely on us each day. As the nation’s largest pharmacy health care provider, we offer a wide range of exciting and fulfilling career opportunities across our three business units – MinuteClinic, pharmacy benefit management (PBM) and retail pharmacy. Our energetic and service-oriented colleagues work hard every day to make a positive difference in the lives of our customers.
CVS Health is an equal opportunity employer. We do not discriminate in hiring or employment against any individual on the basis of race, ethnicity, ancestry, color, religion, sex/gender (including pregnancy), national origin, sexual orientation, gender identity or expression, physical or mental disability, medical condition, age, veteran status, military status, marital status, genetic information, citizenship status, unemployment status, political affiliation, or on any other basis or characteristic prohibited by applicable federal, state or local law. CVS Health will consider qualified job candidates with criminal histories in a manner consistent with federal, state and local laws. CVS Health will not discharge or in any other manner discriminate against any Colleague or applicant for employment because such Colleague or applicant has inquired about, discussed, or disclosed the compensation of the Colleague or applicant or another Colleague or applicant. Furthermore, we comply with the laws and regulations set forth in the following EEO is the Law Poster:
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For inquiries related to the application process or technical issues please contact the Kenexa Helpdesk at 1-855-338-5609. For technical issues with the Virtual Job Tryout assessment, contact the Shaker Help Desk at 1-877-987-5352. Please note that we only accept resumes via our corporate website: https://jobs.cvshealth.com/