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VP PBM Process Innovation

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Woonsocket, RI

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The Vice President of PBM Process Innovation leads a team responsible for advancing our PBM’s operations to provide best in class service at the lowest possible cost. This Vice President role is critical to the successful growth of the PBM business and will drive new innovation that will have a profound impact on the future direction of the company overall. The Vice President will lead multiple teams, each aligned to one or more of the major PBM operational areas, in disruptive and innovative advancements to the operating models of all PBM operations. The scope of responsibility of the PBM Process Innovation team covers the full PBM Cost of Service of over $3 billion annually. This Process Innovation team will deliver >$150 million EBIT value each year and in our largest operations (e.g., Prior Authorization, Customer Care) end up reducing the cost of service by more than 50% over a three-year period. The team is responsible for defining strategic operating model roadmaps, designing technology, work flow, and process improvement solutions, partnering with functional experts (including IT, Digital, operations SMEs, and others) across the organization to build the solutions, and seamlessly and accurately delivering the implementation of those solutions to realize the full business value. The team will own the strategic roadmaps for our operating models, starting with strategic analyses, solution ideation, design, testing, development, and measurement. This team owns planning, design, development, and execution of pilot programs. The Vice President will work closely with senior executives and business partners at all levels of the organization to understand the business and market, guide teams to solve problems, and rapidly deliver new technology and process solutions that support our operations and EBIT performance. This role will have full financial responsibility for all PBM Process innovation, including YoY EBIT growth through expense savings and growth that ties to process enhancements. The role also has full responsibility for the Process Innovation strategic roadmap, capital planning, and ultimately delivering EBIT value to the enterprise.


Strategic Process Innovation Roadmap: Define and lead the strategic roadmap of innovation across all PBM Process Innovation areas, with an addressable expense line of >$3 billion. Identify and prioritize the set of initiatives, solutions, and products, and projects that will drive differentiation and value creation for the PBM through a low-cost, scalable operating model, and build a roadmap that enables speed to market and agility. Scope, plan, and direct teams to deliver quantitative analyses that will yield critical answers to the questions at hand. Understand and help the teams procure the required information to complete the analyses. (Data will often be sourced through observations, tests, interviews, custom data pulls.) Oversee the successful delivery of timely, accurate analyses. Includes leading the team in investigation, problem solving, articulating conclusions, and making recommendations to the leadership team.

Program Delivery: Oversee the day-to-day management for new strategic programs, ensuring that approved projects are on schedule, within budget, and meet the projected ROI through implementation. Engage cross-functionally across the organization to lead teams in designing solutions, developing test and implementation plans, driving results, and resolving issues encountered by the team including the ability to assess and course-correct as necessary.

Communication Development & Business Reporting: Communicates effectively, both verbally and in writing, at the most senior levels of the organization. Leads the development of major presentations for senior internal and external stakeholders. Demonstrates the capacity to synthesize complex information from disparate sources into a clear compelling story.â€

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