Executive Director, Regulatory Management, Network Standards & Technology Transformation

CVS Health•Dallas, AZ

About The Position

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. CVS Caremark is seeking an Executive Director, Regulatory Management, Network Standards & Technology Transformation who is responsible for the strategy, governance, execution, and performance of regulatory implementation, industry standards management, technology modernization, capital investment planning, and transformational initiatives supporting the Pharmacy Network Services organization. This role serves as a critical bridge between business operations, technology, compliance, regulatory affairs, legal, finance, and external industry organizations. The Executive Director is accountable for translating evolving regulatory requirements, industry standards, and business needs into scalable operational capabilities, technology solutions, and enterprise programs that strengthen compliance, improve provider experience, enhance operational efficiency, and create measurable business value. Reporting within Network Services, this leader will provide strategic oversight across regulatory compliance, market conduct examinations, Network Standards, Pharmacy Portal modernization, capital investment governance, and enterprise transformation initiatives. The role blends regulatory expertise, technology leadership, business acumen, and executive influence to drive critical outcomes across a highly matrixed organization.

Requirements

10+ years of progressive leadership experience in PBM, healthcare, pharmacy operations, regulatory compliance, technology, program management, or related healthcare disciplines.
7+ years leading cross-functional teams and enterprise initiatives of increasing complexity.
Demonstrated experience managing large-scale strategic programs, regulatory implementations, technology initiatives, or transformation efforts.
Proven ability to influence senior leaders and drive alignment across highly matrixed organizations.
Experience developing business cases, investment strategies, and executive-level recommendations.
Exceptional communication, presentation, stakeholder management, and executive influence skills.
Demonstrated success balancing competing priorities while delivering measurable business outcomes.

Nice To Haves

PBM, pharmacy benefit, healthcare payer, retail pharmacy, healthcare technology, or regulatory compliance experience.
Knowledge of pharmacy network operations, claims processing standards, provider engagement solutions, and healthcare transaction systems.
Experience supporting regulatory examinations, audits, compliance programs, or government affairs initiatives.
Technology modernization, product management, digital transformation, and capital planning experience.
Knowledge of NCPDP standards and industry governance processes.
PMP, Lean Six Sigma, Agile, or related certifications preferred.

Responsibilities

Lead the assessment, implementation, and governance of state and federal regulatory requirements impacting Pharmacy Network Services.
Provide executive oversight of market conduct examinations, regulatory inquiries, audits, investigations, and compliance-related initiatives.
Partner with Legal, Compliance, Regulatory Affairs, Government Affairs, Finance, Digital, and Operations teams to evaluate business impacts, establish implementation strategies, and ensure timely execution.
Oversee documentation, controls, audit readiness activities, regulatory submissions, and corrective action planning to strengthen organizational compliance and risk management.
Serve as a trusted advisor to executive leadership on regulatory developments, compliance obligations, examination trends, and emerging risks.
Lead enterprise management of pharmacy network standards and regulatory protocols impacting Pharmacy Network Services.
Oversee organizational readiness and implementation for industry-standard initiatives, including NCPDP telecommunications standards and related regulatory requirements.
Serve as executive sponsor for Network Services participation in industry standards organizations and workgroups.
Ensure evolving industry standards, transaction-processing requirements, and external market developments are appropriately evaluated and operationalized.
Represent CVS Caremark externally, as appropriate, in industry forums and standards-related discussions.
Lead strategic technology, modernization, and transformation initiatives that improve Network Services capabilities, provider experience, operational scalability, and regulatory compliance.
Serve as senior business owner and strategic partner for key Network Services technology platforms, digital capabilities, and provider-facing solutions.
Establish and execute multi-year roadmaps focused on automation, workflow simplification, operating model transformation, and modernization of business processes and systems.
Partner with Digital, Technology, Operations, and Finance leadership to prioritize investments, retire manual processes, reduce technical debt, and improve overall business performance.
Drive measurable improvements in efficiency, controls, cost management, stakeholder experience, and enterprise value through technology-enabled transformation.
Lead annual and multi-year technology capital planning activities supporting Pharmacy Network Services strategic priorities.
Develop investment strategies aligned to regulatory obligations, modernization initiatives, operational efficiency objectives, provider experience improvements, and business growth opportunities.
Partner with Finance, Technology, and business stakeholders to prioritize investments, evaluate competing priorities, and optimize resource allocation.
Monitor portfolio performance, benefits realization, budget adherence, and delivery of approved investments.
Present investment recommendations, strategic priorities, and performance updates to senior leadership.
Influence and align leaders across Network Services, Digital, Compliance, Regulatory Affairs, Legal, Finance, Product, Client Services, and Operations on strategic priorities.
Lead executive-level communications, governance forums, business reviews, and strategic planning processes.
Balance regulatory requirements, operational capabilities, financial objectives, and stakeholder needs in highly complex decision-making environments.
Lead and develop high-performing teams responsible for regulatory implementation, Network Standards, technology programs, compliance support, and transformation initiatives.
Establish clear accountability, performance expectations, and development opportunities across the organization.
Build organizational capabilities in strategic planning, program governance, compliance execution, change management, and technology delivery.
Foster a culture of innovation, collaboration, continuous improvement, and operational excellence.
Drive succession planning, colleague engagement, talent retention, and leadership development strategies to ensure organizational continuity and long-term success.