Vice President, CFO, PBM Underwriting & Analytics
Woonsocket, Providence County, Rhode Island, 02895, USA
Listed on 2026-02-28
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Finance & Banking
Financial Manager, Risk Manager/Analyst, CFO, Financial Consultant
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.
VicePresident, Head of Underwriting for Caremark's Health Plan Segment
This role will lead the client pricing, underwriting, analytics, RFP pricing, and client profitability functions for current and prospective PBM health plan clients, including specialty‑only clients, rebate‑only clients, medical rebates, and home infusion.
This is a senior financial leadership role, accountable for profitability, margin performance, and long‑term economic sustainability for a large portfolio. The leader will own client‑level financial outcomes, balancing growth, retention, competitiveness, and profitability across the full client lifecycle.
Key Responsibilities Leadership and Strategy- Lead and manage an organization of approximately 90 colleagues across underwriting, client pricing, RFP pricing, analytics, and client profitability management.
- Establish and execute the underwriting and client profitability strategy aligned to enterprise objectives and segment financial targets.
- Drive a culture of financial accountability, disciplined decision‑making, collaboration, and continuous improvement.
- Partner with senior leadership to define and monitor KPIs that measure pricing effectiveness, profitability, and long‑term client value.
- Oversee the end‑to‑end underwriting and pricing process for PBM health plan clients, including 250+ pricing events annually across new business, renewals, and mid‑term actions.
- Maintain direct accountability for RFP pricing strategy and execution, ensuring competitive, accurate, and profitable pricing outcomes.
- Ensure alignment across pricing offers, negotiations, and contracting with a clear focus on financial risk management and margin protection.
- Continuously review and refine underwriting and pricing processes to improve accuracy, efficiency, and scalability.
- Monitor market trends, competitor dynamics, and regulatory developments to inform underwriting and pricing strategy.
- Interact extensively with executive leadership to align on pricing positions, concessions, and overall underwriting approach.
- Own responsibility for achieving segment‑level revenue and margin objectives through disciplined underwriting and active management of client economics.
- Develop and execute multi‑year financial plans to optimize near‑and long‑term performance.
- Make informed decisions that balance client retention, growth opportunities, and profitability.
- Ensure strong linkage between underwriting assumptions, pricing decisions, and realized financial performance over time.
- Drive delivery of advanced analytics and consultative insights to support client financial performance and pharmacy trend management.
- Leverage data to identify financial risks, opportunities, and emerging trends at both the client and segment level.
- Translate complex financial and utilization data into clear, actionable insights for internal leaders, clients, and consultants.
- Partner with IT and data science teams to enhance analytical tools, financial models, and data infrastructure.
- Serve as a senior leader engaging directly with health plan clients, participating in financial deep dives when detailed discussion of pricing, profitability, or performance is required.
- Build and maintain strong relationships with external stakeholders, including clients and consultants, serving as a trusted underwriting and financial expert.
- Build strong internal partnerships across Client Services, Sales, Proposals, Supply Chain, Legal, Regulatory, Finance, Clinical, and Product teams.
- Act as a subject matter expert on PBM underwriting and client profitability, representing the organization…
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