Director, Client & Regulatory Reporting (Healthcare)

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Position Summary
CVS Health has an exciting opportunity to join our PBM Finance team as Director, Client & Regulatory Reporting (Healthcare). This is a newly created role that will lead and continue to build a best-in-class reporting team. CVS Health strives to continuously innovate around how we analyze and report data to deliver enhanced insights, improve operational efficiency, and provide outstanding customer service. The Director will be a proven leader who has built and managed teams focused on analyzing and reporting processes and improving them through automation, visualization, and operational process improvement initiatives in healthcare. This role will deal with a variety of data including drug rebate, claims, financial, Medicare, Exchange, and operational data. You will be responsible for partnering with leadership to expand upon the tools available to the team in effort to continue to build synergies and efficiencies that will best support operational processes. You will lead all aspects of reporting for internal partners, clients, and regulators. Your innovative approach to reporting will continue to help make CVS Health an industry leader in the healthcare field.
Key Responsibilities

• Continue to build upon existing reporting and analytics infrastructure, building out processes, tools, and capabilities.
• Understand Medicare D operations, regulatory changes and the associated impacts to Medicare D Reporting including but not limited to DIR, MLR, and QHP Reporting.
• Oversee the operational process of taking pricing data from claims system and placing into Medicare D Plan Finder format.
• Become an internal resource to assist with Plan Finder problems and resolve client inquires.
• Manage report scheduling, which tracks recurring reports (e.g., monthly, quarterly, semi-annual, etc.).
• Actively manage and assess staffing levels and capacity to maintain high-quality delivery.
• Respond to requests for ad-hoc reporting, ensuring most impactful reports are being prioritized and executed.
• Proactively assess our current data and identify opportunities to visualize and analyze in new ways, leading to additional insights and predicative analytics.
• Partner with Account Teams, Underwriting, Trade, and other business partners to effectively support all aspects of sharing rebate data
• Partner with Legal, Regulatory, and Compliance teams to ensure rebate data is reported in alignment with regulator guidance
• Implement governance controls to maintain data integrity for the assigned data domain; define processes that identify data related risks and implement on-going control programs to ensure data risks are measured consistently and addressed accordingly
• Ensure the administration and execution of contractual provisions of our PBM client contracts with regard to drug rebate reporting
• Develop intake, prioritization, and assessment process for new data and reporting requests
• Respond to requests for data and reporting, conducting diligence, and ensuring requests will deliver anticipated benefits and service level agreements.
• Resolves escalated client questions and concerns, works with internal partners or the clients when necessary, and pro-actively communicate changes or issues when appropriate.
• Create a system of shared accountability via reporting and analytics dashboards, supporting key business KPIs and distributing actionable intelligence to senior management and business partners.
• Leverage exceptional communication skills including data presentation, using data to help "tell the story".
• Handle, communicate, and escalate issues (as needed) in a timely manner so as not to impact delivery.
• Continuously evaluate / evolve processes, best practices, and tools around data analysis, visualization, and storytelling, bringing the most effective to bear.
• Promote a data-driven culture across the organization by attracting new talent and developing existing employees who can envision and develop a roadmap for insights and analytics capabilities as well as work with delivery partners on implementation.

Required Qualifications
10+ years of experience in leading analytics / reporting initiatives
7+ years in leadership roles
7+ years of experience in financial operations and/or business operations
Preferred Qualifications
Experience in healthcare industry, including health insurance, PBM or pharmacy services
Experience with Medicare D and Medicaid Operations
Experience with Rebate Operations
Experience in highly regulated industry and compliance environment
Experience in customer facing roles
Experience with highly complex, inter-connected systems and business processes
Experience with querying data using tools such as Access and SQL
Experience overseeing significant IT capital projects as a business user from requirements through to deployment
Process Improvement training / certification (such as Lean Six Sigma)
Education
Bachelor degree or equivalent works experience required
Master's degree preferred
Pay Range
The typical pay range for this role is:
$100,000.00 - $227,000.00
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.
In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company's 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off ("PTO") or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.
For more detailed information on available benefits, please visit jobs.CVSHealth.com/benefits
CVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated.
You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.
CVS Health is committed to recruiting, hiring, developing, advancing, and retaining individuals with disabilities. As such, we strive to provide equal access to the benefits and privileges of employment, including the provision of a reasonable accommodation to perform essential job functions. CVS Health can provide a request for a reasonable accommodation, including a qualified interpreter, written information in other formats, translation or other services through ColleagueRelations@CVSHealth.com If you have a speech or hearing disability, please call 7-1-1 to utilize Telecommunications Relay Services (TRS). We will make every effort to respond to your request within 48 business hours and do everything we can to work towards a solution.