AVP, Pharmacy Operations & Strategy

AVP, Aetna Pharmacy

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The AVP, Aetna Pharmacy will provide day-to-day leadership, operational oversight, and strategic execution across Aetna Pharmacy's portfolio. This includes direct responsibility of all pharmacy functions across the Medicare, Medicaid, and Commercial lines of business and Aetna Pharmacy Strategy & Operations. This leader will translate enterprise pharmacy strategy into actionable plans, manage operational performance, and ensure strong alignment and partnership with the IBU/PBM, Aetna business segments, Enterprise Pricing, and clinical and product partners. Working closely with the VP, Aetna Pharmacy and Value Management, the AVP will drive execution on our critical priorities: optimize pharmacy and medical pharmacy total cost of care, deliver a seamless member/provider experience, accelerate operational excellence, and collaborate for enterprise growth.

Key Responsibilities

• Lead daily management of Aetna Pharmacy operations, performance oversight, and execution of strategic initiatives across all lines of business.
• Under direction of VP, develop and own a multi-year pharmacy strategy, ensuring near-term execution decisions, investments, and priorities are aligned to and advance long-term affordability, experience, and growth objectives.
• Drive pharmacy performance outcomes including trend mitigation and clinical quality improvement in alignment to regulatory, contractual, and audit requirements.
• Partner with Aetna Medicare, Medicaid, and Commercial leadership to:
  • Align pharmacy goals and KPIs to line of business strategies,
  • Support benefit design, formulary execution, pipeline monitoring, Stars pharmacy measures, and service delivery,
  • Coordinate performance reviews, trend analysis, operational updates, and improvement plans across each business.
• Serve as primary day-to-day liaison with enterprise partners (e.g., IBU/PBM, CVS Specialty, and Retail) to ensure best-in-class pharmacy capabilities, timely operational support, and operational issues are triaged and resolved quickly.
• Facilitate ongoing activities related to rebate forecasting, formulary execution, adherence to guarantees, clinical programs, underwriting support, and product design inputs.
• Coordinate closely with Enterprise Pricing, Actuarial, Clinical, Product, and Service teams to ensure integrated execution and alignment.
• Lead operational components of Aetna's pharmacy trend strategy, including analysis, reporting, and execution of trend-mitigating SAIs and clinical interventions.
• Own pharmacy contributions to member and provider experience improvement, including simplification of utilization management workflows and reduction of administrative friction.
• Proactively identify risks, operational issues, and improvement opportunities, and drive process enhancements to improve timeliness, accuracy, and member and provider experience.
• Build, lead, and develop a diverse, high-performing team with expertise in pharmacy operations, strategy, analytics, and cross-functional execution.
• Foster a culture that values collaboration, accountability, operational rigor, and continuous improvement.
• Prepare materials and represent Aetna Pharmacy for VP+ level and executive updates including performance reports, strategic initiative updates, trend results, and financial/clinical outcomes.

Location: Remote or Hybrid

Requirements

• 12+ years of experience in health plan pharmacy, PBM, or related healthcare roles with progressive leadership and increasing operational responsibility.
• Deep understanding of health plan and PBM operational dynamics, including pharmacy financial drivers, clinical quality programs, and pharmacy benefit strategy with demonstrated ability to translate strategy into execution.
• Working knowledge of formulary strategy, rebate structures, and PBM economics, with experience applying these levers to drive performance outcomes.
• Solid knowledge of utilization management and the interplay between pharmacy and medical benefit dynamics with experience operationalizing programs at scale.
• Demonstrated ability to navigate complex stakeholder environments, including engaging with external clients and influencing senior internal stakeholders.
• Proven experience leading and influencing in a highly matrixed environment, partnering across enterprise stakeholders to drive alignment and decision-making, including managing up and driving decisions in complex organizational structures.
• Strong analytical capabilities, with the ability to interpret trend, financial, and operational data and translate insights into action and execution plans tied to measurable outcomes.
• Track record of driving performance improvement and managing multiple, concurrent initiatives at scale with clear accountability for results (e.g., cost of care, trend, quality, or experience).
• Excellent interpersonal, communication, and relationship-building skills, with the ability to engage effectively across all levels of the organization including VP+ leadership.

Pay Range: $157,800.00 - $363,936.00

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. This position also includes an award target in the company's equity award program.

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. 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.

Additional details about available benefits are provided during the application process.