Manager Project Management - Pharmacy Compliance

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Position Summary

The Aetna Pharmacy Health Plan Compliance team is seeking an experienced professional with Health Care compliance experience to join our team. Our mission is to assess the applicability of State and Federal regulations to our commercial Aetna pharmacy programs and benefit plans, to identify and track business and compliance risks and issues and to develop and implement action plans to become compliant. Our team collaborates with both the Aetna Health Plan business teams and with our CVS Caremark PBM colleagues to understand regulatory trends and to anticipate impacts. Our regulatory environment is ever-changing. Our team works with urgency to anticipate, understand and address new regulatory requirements which impact the Aetna Pharmacy Health Plan and to drive our organization to new levels of efficiency through continuous process improvement activities.

Successful candidates for this position will be able to:

• Review and assess new state and Federal legislative requirements to determine applicability to the Aetna Pharmacy Health Plan.

• Research impacts of new legislation to our existing systems, processes, policies and technology platforms.

• Summarize and present new legislation and its applicability to the Aetna Pharmacy Health Plan to internal and external colleagues to make them aware of impacts to their business areas and to solicit their ideas and support for developing a solution to become compliant before the effective date of new mandates.

• Collaborate closely with internal Health Plan and PBM business teams in a fast-paced environment. 

• Request reports and analyze data to understand the business impact of new legislation to fully insured Aetna commercial members and plan sponsors.

• Participate in or lead work group discussions to understand and document the interdependencies of business areas to become compliant, present information and complex data in a clear and concise manner. 

• Develop project plans, document dependencies, engage resources and track project deliverables to completion.

• Manage multiple compliance projects from end-to-end at the same time.

• Adhere to team reporting metrics for mandate tracking.

• Take ownership and accountability and demonstrate leadership in pursuit of compliance.

• Join forces with team members to analyze and review incoming legislation.

Required Qualifications

• A minimum of 5 years of experience in pharmacy benefit management, pharmacy operations or managed healthcare. 

• A minimum of 3 years project management experience. 

• Strong organizational skills, problem solving skills and critical thinking capabilities. 

• Able to communicate to multiple levels of leadership. 

• Functions independently to meet deadlines while managing multiple competing priorities. 

• Proficient in MS Office Suite, including MS Excel, MS Outlook, MS PowerPoint, MS SharePoint and MS Teams.

Preferred Qualifications

• General understanding of the legislative review process.

• Capable of building the trust and respect of internal and external constituents. 

Education

• Bachelor's degree preferred or a combination of professional work experience and education.

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is:

$54,300.00 - $159,120.00

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. 
 

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.