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 Vice President, Formulary and Clinical Program Strategy is a senior executive leader responsible for end-to-end clinical pharmacy strategy across formulary management, utilization management, clinical program development, and clinical oversight. This role is responsible for strategic formulary management and utilization management development, positioning core clinical pharmacy operations within a unified, highly integrated governance and execution model.
This VP provides leadership to ensure that formularies, utilization management criteria, and clinical programs are clinically appropriate, evidence based, compliant, scalable, and aligned to CVS Health’s affordability, quality, and growth strategies. The role serves as a key clinical authority and executive partner across PBM, Health Plans, Specialty, Omnicare, Trade, Finance, Product, Regulatory, and Legal.
Strategy, Collaboration & Integration
- Own and lead formulary strategy across Commercial, Health Exchange, Managed Medicaid, Aetna Fully Insured, and Medicare Part D lines of business.
- Serve as the clinical pharmacy strategist, aligning formulary, utilization management, and clinical program strategy across all CVS Health business units, including PBM, Health Plans, Specialty, Omnicare, Trade, Product, and Finance.
- Actively drive collaboration across business units, ensuring clinical strategies are integrated, scalable, and responsive to diverse customer and member needs.
- Partner closely with senior leaders across Medical Affairs, Product, Digital, Technology, Regulatory, and Legal to ensure clinical strategies are embedded into priorities and roadmaps.
- Establish governance models that enable consistent decision‑making while allowing for line‑of‑business flexibility where required.
Formulary & Utilization Management Strategic Oversight
- Provide strategic oversight of formulary and utilization management strategy across all lines of business, including Commercial, Exchange, Managed Medicaid, Aetna Fully Insured, and Medicare Part D.
- Set the strategic direction and guardrails for formulary design, drug coverage approaches, and UM criteria, while delegating day‑to‑day execution and maintenance to Executive Directors.
- Ensure alignment between formulary strategy, UM design, clinical evidence, regulatory requirements, and affordability objectives.
Clinical Pharmacy Programs & Governance Leadership
- Lead the clinical PBM program strategy, including prioritization, governance, and lifecycle oversight for clinical programs addressing safety, adherence, optimization, and gaps in care.
- Oversee Clinical Program Oversight (CPO) and P&T governance structures, ensuring clinical independence, rigor, and defensibility.
- Rely on Executive Directors and senior clinical leaders for program execution, implementation, and operational performance management.
Digital, Technology & Innovation Integration
- Champion the integration of digital and technology capabilities into formulary, utilization management, and clinical program strategies.
- Partner with Digital and Technology teams to ensure clinical strategies are supported by scalable platforms, data analytics, automation, and decision‑support tools.
- Drive innovation by leveraging technology to improve speed to decision, transparency, member/provider experience, and clinical outcomes.
- Ensure clinical requirements are clearly articulated and embedded into technology roadmaps and transformation initiatives.
Clinical Pipeline, Analytics & External Insight
- Provide strategic oversight of Clinical Pipeline Services and emerging therapy intelligence to proactively inform enterprise strategy.
- Ensure pipeline insights are translated into forward‑looking formulary, UM, and clinical program strategies, rather than reactive decision‑making.
- Maintain awareness of external clinical, regulatory, and market trends to guide long‑term positioning.
Leadership Model & Operating Expectations
- Lead through a clear strategic‑oversight model, empowering Leaders to own execution, delivery, and tactical operations.
- Establish clear decision rights, accountability frameworks, and performance expectations across the organization.
- Develop senior clinical leaders capable of operating at scale and navigating complex cross‑business dynamics.
Qualifications
- PharmD required; Board Certification (e.g., BCPS) strongly preferred.
- Active pharmacist licensure required.
- 15+ years of progressive leadership experience in managed care, PBM, health plan, or integrated healthcare environments.
- Deep expertise in formulary management, utilization management, clinical program governance, and P&T Committee operations.
- Demonstrated ability to operate at enterprise executive level, balancing clinical integrity, regulatory rigor, and business strategy.
Pay Range
The typical pay range for this role is:
$300,000.00 - $400,000.00
Pay Range
The typical pay range for this role is:
$0.00 - $0.00
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.
Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
Great benefits for great people
We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.
This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.
Additional details about available benefits are provided during the application process and on Benefits Moments.
We anticipate the application window for this opening will close on: 05/12/2026
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.