Sr Mgr, Aetna Medicare Medical Pharmacy (Pharmacist)

At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day. As the Senior Manager, Aetna Medicare Medical Pharmacist, you will play a key role in the development and execution of business strategies and programs within the Medicare Part B Pharmacy Team. You will act as a Subject Matter Expert for Part B and specialty drugs. Key areas of responsibility include utilization management, clinical programs, and operational excellence. Responsible for overseeing and problem-solving daily strategy and operations issues within Medicare Part B. Partners with key stakeholders to optimize the achievement of strategic business objectives, including improving clinical outcomes and cost-effective care. • *Fundamental Job Components:** + Lead the long-term vision and strategy around Part B drug management related to utilization management (UM), clinical programs, and pharmacy operations. + Lead the day-to-day implementation and operations around Part B drug strategies related to UM, clinical programs, and pharmacy operations. + Monitor the Part B drug and specialty drug pipelines for innovative drug therapies and trend drivers, ensuring alignment with business objectives. + Effectively resolve internal and external escalations and clearly document results. + Identify gaps and recommend enhancements related to new and/or existing products, services, and workflows based on a broad view of the organization. + Outreach to members and providers to optimize clinical outcomes and cost-effective care. + Drive operational excellence around Part B drugs including UM and claims processes and systems. + Conduct and lead meetings/presentations with cross-functional business partners and external parties, including market leads, employer group stakeholders, and vendor partners, ensuring team participation and collaboration. + Other duties as assigned Other: + Active, unrestricted pharmacist license in state of residence + 5+ years of relevant work experience in a PBM or health plan preferred + Experience managing complex processes that require strong attention to detail + Proven ability to collaborate effectively across cross functional teams and build strong relationships. + Exceptional problem-solving and decision-making skills. + Growth mindset with a focus on agility, continuous learning, and development. + Proficient user of Excel, PowerPoint, Word Education: + PharmD or equivalent is required • *Pay Range** The typical pay range for this role is: $67,900.00 - $199,144.00 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 our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include: + **Affordable medical plan options,** a **401(k) plan** (including matching company contributions), and an **employee stock purchase plan** . + **No-cost programs for all colleagues** including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. + **Benefit solutions that address the different needs and preferences of our colleagues** including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit We anticipate the application window for this opening will close on: 10/30/2025 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. We are an equal opportunity and affirmative action employer. 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. At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day. As the Senior Manager, Aetna Medicare Medical Pharmacist, you will play a key role in the development and execution of business strategies and programs within the Medicare Part B Pharmacy Team. You will act as a Subject Matter Expert for Part B and specialty drugs. Key areas of responsibility include utilization management, clinical programs, and operational excellence. Responsible for overseeing and problem-solving daily strategy and operations issues within Medicare Part B. Partners with key stakeholders to optimize the achievement of strategic business objectives, including improving clinical outcomes and cost-effective care. • *Fundamental Job Components:** + Lead the long-term vision and strategy around Part B drug management related to utilization management (UM), clinical programs, and pharmacy operations. + Lead the day-to-day implementation and operations around Part B drug strategies related to UM, clinical programs, and pharmacy operations. + Monitor the Part B drug and specialty drug pipelines for innovative drug therapies and trend drivers, ensuring alignment with business objectives. + Effectively resolve internal and external escalations and clearly document results. + Identify gaps and recommend enhancements related to new and/or existing products, services, and workflows based on a broad view of the organization. + Outreach to members and providers to optimize clinical outcomes and cost-effective care. + Drive operational excellence around Part B drugs including UM and claims processes and systems. + Conduct and lead meetings/presentations with cross-functional business partners and external parties, including market leads, employer group stakeholders, and vendor partners, ensuring team participation and collaboration. + Other duties as assigned Other: + Active, unrestricted pharmacist license in state of residence + 5+ years of relevant work experience in a PBM or health plan preferred + Experience managing complex processes that require strong attention to detail + Proven ability to collaborate effectively across cross functional teams and build strong relationships. + Exceptional problem-solving and decision-making skills. + Growth mindset with a focus on agility, continuous learning, and development. + Proficient user of Excel, PowerPoint, Word Education: + PharmD or equivalent is required • *Pay Range** The typical pay range for this role is: $67,900.00 - $199,144.00 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 our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include: + **Affordable medical plan options,** a **401(k) plan** (including matching company contributions), and an **employee stock purchase plan** . + **No-cost programs for all colleagues** including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. + **Benefit solutions that address the different needs and preferences of our colleagues** including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit We anticipate the application window for this opening will close on: 10/30/2025 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. We are an equal opportunity and affirmative action employer. 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. Apply tot his job