Senior Manager, Project Management – Pharmacy Compliance

CVS Health

9d•$67,900 - $182,549•Remote

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. The Senior Manager, Project Management – Pharmacy Compliance leads strategic compliance initiatives across Aetna Pharmacy Health Plan programs, ensuring adherence to evolving state and federal regulations. As a subject matter expert on legislation, regulatory requirements, and compliance initiatives impacting pharmacy programs and prescription drug products administered through both the pharmacy and medical, this role provides strategic guidance, regulatory interpretation, and leadership across implementation and regulatory readiness activities. The Senior Manager partners with stakeholders to assess impacts, mitigate compliance risks, and support regulatory initiatives, including oversight of prior authorization and utilization management activities for prescription drug products processed through the medical benefit. This leader plays a key role in shaping compliance strategy and mentoring project managers to drive effective execution and delivery.

Requirements

7+ years of experience in pharmacy benefit management, pharmacy operations, managed healthcare, compliance, regulatory affairs, or related healthcare functions.
5+ years of project management experience, including leadership of complex compliance or regulatory initiatives.
Strong knowledge of healthcare regulatory environments and legislative review processes.
Proven ability to lead cross-functional teams and manage multiple high-impact initiatives simultaneously.
Strong analytical, problem-solving, and decision-making skills.
Exceptional communication, collaboration, and stakeholder engagement skills.
Proficiency in Microsoft Office Suite, including Excel, Outlook, PowerPoint, SharePoint, and Teams

Nice To Haves

Experience interpreting and implementing healthcare legislation and regulatory requirements.
Knowledge of pharmacy benefit programs and prescription drug products administered through the medical benefit.
Experience supporting compliance programs, regulatory implementation activities, prior authorization, utilization management, or related operational processes.
Demonstrated ability to influence stakeholders and drive complex cross-functional initiatives in a highly matrixed environment.
Experience mentoring, coaching, or leading project managers and project teams.
Project Management Professional or other relevant project management certification.

Responsibilities

Lead strategic compliance initiatives and complex cross-functional projects impacting pharmacy programs and prescription drug products administered through the pharmacy and medical.
Serve as a subject matter expert on legislation, regulatory requirements, and compliance initiatives, providing regulatory interpretation, impact assessments, and implementation guidance.
Oversee compliance activities and operational processes, including prior authorization and utilization management requirements for prescription drug products processed through the medical benefit.
Partner with Pharmacy, Medical Pharmacy, PBM, Legal, Clinical, Operations, and business stakeholders to implement regulatory changes, mitigate compliance risks, and ensure business readiness.
Support regulatory inquiries, audits, reporting, monitoring activities, and compliance governance efforts.
Drive regulatory readiness, process improvement, and operational effectiveness across compliance programs.
Mentor and develop project managers while helping shape compliance strategy and execution across the organization.