CVS Health

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Clinical Client Operations Director

at CVS Health

Job Description

Clinical Client Operations Director

No. of Positions

Position Summary
As a Clinical Client Operations  Director, you will play a key leadership role on our Clinical and Specialty Programs teams. You will lead an operational team that function as the Caremark PBM organizations’  clinical program  experts, and own and execute all clinical functions from the creation to  maintenance within RxClaim. This includes our Caremark PBM formulary standard templates (commercial, Med D. Medicaid and exchanges in RxClaim  and in   Specialty (specialty exclusive networks and preferred rates). This role  supports  critical RxClaim drug file information as well as supporting other Caremark programs including step therapy, health care reform, specialty guideline management and more. This is an excellent opportunity to work cross functionally across the Pharmacy Benefits Management (PBM) segment to technically lead and process improve the functions aligned in the Clinical Programs  and Specialty  process and establish new, innovative capabilities. Equally important is the  leadership requirement for change management execution and for the continual development of people, process and tools in an  dynamic environment. 

This will be accomplished by:

-Leadership, management and development of a team of Clinical Client  Operations  and Specialty experts who  consult with clients to implement clinical solutions and then code into Rxclaim

-Standardizing clinical requirements documentation processes, protocols and technology strategies to ensure maximum effectiveness, efficiency and to work on a Lean basis ensuring top quality

-Creating flawless execution strategies and efficient new models of operation in a dynamic, fast paced environment

-Leading, managing, supporting and brining creativity in working with key matrix partners in the PBM arena: helping the team be the best it can be for our clients  and in our work. Demonstrate and drive change management skillsets and behaviors throughout the team and the organization.

-Sponsoring , executing and communicating on key projects that provide automation improvement, efficiency gains  in production and quality 

Your focus in this role will be to create and develop a high performing team that will continue to define the clinical requirements road map within the benefit and coding process.    The execution of this team and position will drive the CVS Health Clinical requirement capabilities forward through flawless execution to our clients and members.  You will have the unique opportunity to create new strategies to ensure a superior quality output to include developing customized solutions unique to each line of business, designing work process solutions that will drive efficiency, build quality into the process and provide superior support to both new and existing clients.    

You will also bring to the market leading clinical technology solutions that facilitate both superior service and quality. The role will be building all solutions and creating new organizational capabilities and to be successful, this role is responsible must excel in attracting and building a high performing team. 

Req ID

Sourcing Requisition


Business Area
CVS Health

Location - State/City
AZ - Scottsdale, IL - Northbrook, RI - Woonsocket, TX - Irving

Job Category


Preferred Qualifications
* Clinical PBM experience is desired. 

United States

Job Type (Expected Hours Category)
Full Time

Street Address
750 W John Carpenter Fwy Ste 1200

Location code

Requisition Template

Bachelor's degree required; equivalent work experience may substitute. 


Clinical Licensure Required

Zip Code

Required Qualifications
* 9+ years of experience in process improvement, change management, process improvement, or related field. 

* 9+ years of experience in the healthcare/PBM industry, with a focus on people, process, tools, innovation, and technology.  

* 7+ years of leadership experience, with proven experience developing and coaching high performing teams. 

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: EEO IS THE LAW and EEO IS THE LAW SUPPLEMENT

Federal law requires employers to provide reasonable accommodation to qualified individuals with disabilities. If you require assistance to apply for this job, please contact us by clicking EEO AA CVS Health

CVS Health does not require nor expect that applicants disclose their compensation history during the application, interview, and hiring process.

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:

Application Instructions

Please click on the link below to apply for this position. A new window will open and direct you to apply at our corporate careers page. We look forward to hearing from you!