Description
CVS Health is seeking an exceptional technology leader to serve as Associate Vice President of Adjudication Services for CVS Caremark. This leader will own the technology strategy, transformation, delivery and operational performance of the prescription claims adjudication platform and its broader ecosystem across Commercial Programs, Government Services and Enterprise Strategic initiatives.
The role carries end-to-end accountability for a mission-critical business outcome - processing prescription claims reliably, securely and at scale while evolving the platform for the future.
Responsibilities
- Mission-critical outcomes. Be accountable for the availability, performance, accuracy and compliance of the claims processing platform that clients, members, pharmacies and partners rely on every minute of every day.
- One strategy across Commercial, Government and Strategic portfolios. Create a North Star vision for the adjudication services ecosystem and turn it into an executable roadmap that aligns people, process and technology.
- Transformation through Innovation. Provide hands-on impetus to the ongoing shift from existing applications to a cloud-native, microservices-based, domain-driven architecture while keeping the claims processing platform highly efficient.
- Integration and interoperability. Set the direction for API first strategy, governance and lifecycle management, and for real-time and batch integration across internal platforms, clients, prescribers, networks and external partners.
- AI and automation. Embed AI, DevSecOps, test automation and simplified architecture into how we build and run the platform, with the goal of moving the organization from reactive operations to predictive operations.
- Business partnership. Partner as a peer with senior leaders across Operations, Product, Client Services, Network Management, Pricing, Data and Integration Services, and Client Experience Engineering to prioritize investments and deliver shared results.
- Portfolio and financial stewardship. Manage a large multi-program investment portfolio and cost base, ensuring delivery that is on time, on budget and at the quality our business demands.
- Resilience and regulatory excellence. Anticipate growth, performance and end-of-life risks before they become problems, and ensure compliance with HIPAA, NCPDP, CMS and other regulatory requirements across every program.
- People and culture. Lead, grow and inspire a high-performing organization of exec directors, directors, managers, engineers and partners.
- Ecosystem and industry leadership. Partner with technology providers and third parties to accelerate innovation, and stay ahead of industry shifts, new business models and emerging technology so our platform is ready for what comes next.
Requirements
- 15+ years of progressive experience in technology, software engineering, application delivery or platform leadership, including leadership of large, complex organizations and enterprise portfolios over $50M+ accountability.
- Demonstrated success leading deep technology and business transformation in a large, matrixed and highly regulated environment.
- Experience owning mission-critical platforms with demanding requirements for availability, performance, resilience, security and operational support.
- Proven ability to lead large-scale transformation involving core platforms, AI, cloud technologies, service-based or microservices architectures, enterprise application integration, API strategy and lifecycle management, and system interoperability.
- Strong financial and portfolio management experience, including investment prioritization, workforce planning, vendor management and delivery accountability.
- Exceptional stakeholder management and influencing skills, with the ability to align senior business and technology leaders around difficult choices and shared outcomes.
- Ability to move comfortably between strategy and technical detail, communicate complex issues in plain language and make sound decisions under pressure.
- Demonstrated success leading organizational change, building high-performing leadership teams and creating a culture of accountability, innovation and continuous improvement.
Benefits
This full-time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well-being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.