Executive Director, Benefits Operations

Job DescriptionThe Executive Director Client Services will be responsible and lead a team of roughly 200 employees. This includes contractors, as well employees and leaders at varying levels. The team will focus on a specific client(s) for Health Plans across the Medicare, Medicaid, and Exchange lines of business. The Executive Director focuses on three functional areas: benefits requirements, configuration, and testing. This role includes defining the strategic direction for the team to achieve business and regulatory objectives with a strong focus on continuously improving quality while efficiently scaling services using automation. Executive Director is responsible for managing the $19M team budget along with achieving service warranties and performance guarantees budgets. This role will have high-levels of collaboration across the enterprise with key business partners; including but not limited to: Senior Leadership, Account Management, Sales, IT, Clinical, Internal Audit, Medical Affairs, Government Operations, and Human Resources. Along with high interactions with the assigned client(s); to ensure service expectations are being achieved year over year. Responsibilities: Defines strategies to improve the implementation and maintenance of plan benefits for Health Plan Government clients. Leads team in the execution of the strategies. Builds a high-performing team by providing opportunities, guidance and feedback to develop colleagues and ensure a pipeline of talent for the future growth. Lead process improvements initiatives across requirements, configuration, and testing to improve quality and increase team efficiency. Ensures team's critical metrics, strategic projects, and compliance objectives are achieved by team. Partners with Senior Leaders across Account Management, Sales, Clinical, IT, Internal Audit, Medical Affairs, and Government Operations to ensure client expectations are accurately being set and achieved. Engages with clients to ensure expectations are being met.Required Qualifications 8+ years of experience in PBM, Managed care or other healthcare industry, or related transferable experience 10-15 years of progressive leadership experience; leading leaders, and levels of employees. Both non-exempt and exempt. Past experience for overseeing and meeting a budget, and KPIs Strong communicator, both verbal and written, with executive presence and the ability to influence across functions and at all levels of an organization Highly organized and proven ability to build and lead high performing teams Ability to handle multiple and often challenging priorities Ability to think both strategically and tactically along with a willingness to challenge the status quo to ensure the department reaches higher levels of performance Experience working in a matrix environmentCOVID RequirementsCOVID-19 Vaccination RequirementCVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated. You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.Preferred Qualifications Experience in the healthcare industry with in-depth knowledge of pharmacy benefits management operations for Medicare, Medicaid, and Exchange is preferred.EducationBachelor's Degree, or 4 year's equivalent work experience.Master's Degree Preferred.Business OverviewBring your heart to CVS HealthEvery one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at its center - our purpose sends a personal message that how we deliver our services is just as important as what we deliver.Our Heart At Work Behaviors support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable. We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.

Created: 2025-11-15