Executive Director of Retail Health Payer Contracting at CVS Health

Rhode Island

$131,500 – $303,195 / year

H1B Visa Sponsor B2B Healthcare Healthcare Insurance

Description

Shape payer contracting strategies to support Retail Health priorities, growth goals, and care delivery models.
Analyze payer, reimbursement, and healthcare market trends to inform contracting decisions.
Counsel senior leaders on payer strategy, contracting opportunities, risks, and results.
Build and guide a strong payer contracting team.
Direct complex negotiations, renewals, amendments, and strategic discussions with national and regional health plans.
Develop senior payer relationships and identify potential partnerships.
Review reimbursement terms, contract economics, financial opportunities, and risks.
Manage the payer contract portfolio to meet financial, operational, and strategic goals.
Track contract results and improve reimbursement, contract value, and overall performance.
Work with Finance, Legal, Revenue Cycle, Operations, Clinical, and Compliance teams on contract development and execution.
Resolve major payer contracting issues, disputes, and escalations.

Requirements

At least 15 years of progressive healthcare experience, including substantial payer or managed care contracting work.
Track record of setting payer strategy, leading complex healthcare contract negotiations, and managing senior payer relationships.
Strong knowledge of healthcare reimbursement models, contract economics, payer-provider relationships, and contract performance.
Strong financial and analytical judgment.
Excellent negotiation, executive communication, relationship-building, and influencing abilities.
Ability to lead within a complex, highly matrixed healthcare organization and align stakeholders.
Experience leading and developing effective teams.
Extensive work with national and regional health plans and government and commercial payer contracting is highly valued, particularly in ambulatory, physician, or retail health settings.
Bachelor’s degree required.
Advanced degree preferred.

Benefits

CVS Health bonus, commission, or short-term incentive program.
Target award through the company’s equity award program.
Medical coverage.
Dental coverage.
Vision coverage.
Paid time off.
Retirement savings options.
Wellness programs.
Other resources supporting physical, emotional, and financial well-being.

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