Senior Financial Operations Manager, PBM

Job DescriptionCVS Health has an exciting opportunity to join our PBM Finance team as a Senior Manager, PBM Financial Operations - Member Services. This is a newly created role that will report to the Lead Director, Finance Operations - Member Experience, and will lead a team focused on driving superior operational performance and service excellence. The Sr. Manager will oversee multiple member experience functions including member dispute resolution and coordination of benefits for members with multiple levels of prescription drug coverage. Other areas may be assigned as dictated by evolving business needs. The Senior Manager will be a dynamic leader with deep operational customer-facing expertise. The role will require excellent organizational and communication skills, with an ability to lead multiple teams while also driving strategic initiatives.1. Partner with finance and enterprise teams to establish best-in-class member experience 2. Participate in technology solutions that reduce the use of paper and postage3. Partner across Operations Teams to constantly drive and execute process improvements both through automation and operational processes4. Member Disputes - Lead Member Dispute Team to provide efficient and timely resolution to member issues pertaining to payments and billing5. Coordination of Benefits - Lead Medicare COB team to actively pursue primary payers and ensure accurate claim adjudication6. Systems strategy and operational enablement: partner with operations, Finance Ops Enablement, and IT to develop and execute long-term systems and enabling capabilities roadmapRequired Qualifications- 7+ years of experience in financial and/or service operations - 5+ years in leadership; management roles; managing people - 5+ years; Direct customer facing experienceCOVID 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 healthcare industry, including health insurance, PBM or pharmacy services Experience in highly regulated industry and compliance environment General Knowledge of Medicare Part D Experience with SAP, RxClaim, PeopleSafeEducationBachelor's Degree or equivalent year's of experience requiredBusiness 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: 2025-10-04