Executive Director Payer Relations Analytics
Executive Director Payer Relations Analytics
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$ 131500 - 303195
1 Vacancy
Job Description
At CVS Health were building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.
As the nations leading health solutions company we reach millions of Americans through our local presence digital channels and more than 300000 purposedriven colleagues caring for people where when and how they choose in a way that is uniquely more connected more convenient and more compassionate. And we do it all with heart each and every day.
Position Summary:
The Executive Director Payer Relations Analysis will act as a strategic thought partner for Retail Payer Relations. The role will have subject matter expertise on pharmacy economics PBM reimbursement patient/customer characteristics & use of claim transaction data for business insights. The role will drive value by Identifying exploring and developing ideas of margin opportunity for Retail Pharmacy with a specific focus on areas within the PBM and Plan Sponsor space.
Additionally the role works cross functionally to complete tactical fast paced assessments deliver recommendations aid implementation and measure results for the various retail pharmacy initiatives.
An ideal candidate exhibits an intellectual curiosity to understand the dynamics shaping the pharmaceutical industry the tenacity to address complex business problems and leadership skills to direct crossfunctional teams.
The Executive Director Payer Relations Analysis will lead a team of 35 people of varying levels providing leadership for project prioritization and managing stakeholders and coaching/mentoring team members to develop their skills.
Responsibilities:
- Identify explore and develop ideas of margin opportunity for Retail Pharmacy with a specific focus on areas within the PBM and Plan Sponsor space. Present recommendations to Sr leaders (SVP Payer Relations and SVP Retail Pharmacy) including options for implementation aligned with necessary internal stakeholders. Examples may include items such as brand DAW strategies impact of contract language network mix trends Med D landscape implications identifying sources of margin leakage vs expectations etc.
- Enhance maintain and evolve a suite of reporting and analytics for use by the broader Payer Relations team to manage payer account performance vs expectations identify trends and understand key data points related to payers.
- Ownership of Retail Pharmacy profitability data infrastructure (Palantir Foundry) which is a $15M annual licensed data platform used across >200 business users for business case development and analytical insights.
- Develop and deploy tools that streamline analytics work within Retail Pharmacy. Coordinate across Retail pharmacy business partners AB&C & IT to efficiently implement these tools.
- Manage team of approximately five individuals to accomplish these goals. Develop cross business unit expertise to enable quick project ideation and evaluation.
Required Qualifications:
- 10 plus years of knowledge in relevant aspects of the PBM/Payer/Retail Pharmacy industry dynamics and landscape.
- Executive level consulting experience in translating business problems across disciplines into advanced analytic projects with measurable business value combined with ability and experience to work closely with the individual contributors to efficiently translate plans into reality.
- Demonstrated experience evaluating projects based on business value and ROI.
- Analytics experience within the retail and/or healthcare industries with experience deploying capabilities across a wide range of business disciplines and creating solutions to a variety of problems.
- Ability to manage/mentor/develop team members and build a supportive high performing culture.
- Proven ability to establish and maintain collaborative relationships with nonanalytic business partners including executive leadership in order to elicit business needs and formulate propose and refine technical solutions in order to meet the business needs and to drive efficiency and effectiveness improvements and business value.
- Excellent written and oral communication and data presentation skills with ability to tailor the communication style to the right audience from the analytic professional to the senior business leaders.
- Excellent project management skills with ability to lead and engage in multiple projects and initiatives and appropriately prioritize her/his own time as well as that of the direct reports.
Preferred Qualifications:
- Solid understanding of pharmacy economics PBM reimbursement patient/customer characteristics and use of claim transaction data for business insights.
- Solid understanding and hands on experience with a variety of analytic processes and techniques including health economics outcomes research measurement methodologies development hypothesis testing statistical significance testing modeling and data science.
- Solid understanding and hands on experience working with large data sources particularly administrative claims and clinical program data focusing on efficient data extraction from large databases data manipulation and setting up optimized summary data layers.
Education:
- Bachelors degree Required
- Masters degree Preferred
Pay Range
The typical pay range for this role is:
$131500.00 $303195.00
This pay range represents the base hourly rate or base annual fulltime 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 shortterm incentive program in addition to the base pay range listed above. This position also includes an award target in the companys 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 our comprehensive and competitive mix of pay and benefits investing in the physical emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages our great benefits include:
Affordable medical plan options a 401(k) plan (including matching company contributions) and an employee stock purchase plan.
Nocost programs for all colleagues including wellness screenings tobacco cessation and weight management programs confidential counseling and financial coaching.
Benefit solutions that address the different needs and preferences of our colleagues including paid time off flexible work schedules family leave dependent care resources colleague assistance programs tuition assistance retiree medical access and many other benefits depending on eligibility.
For more information visit anticipate the application window for this opening will close on: 05/16/2025 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal state and local laws.
Required Experience:
Director
Employment Type
Full-Time
