Executive Director, Payer Contracting Retail Health

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Executive Director Payer Contracting Retail Health

Position Summary

The Executive Director Payer Contracting leads payer contracting strategy for Retail Health with responsibility for contract negotiations payer relationships financial performance and contract execution. This leader will develop and advance payer strategies that support business growth patient access and sustainable financial performance while ensuring contractual arrangements align with the clinical and operational needs of the business.

The Executive Director serves as a key strategic partner across Finance Legal Operations Revenue Cycle Clinical Compliance and other enterprise stakeholders bringing together payer strategy financial insight and operational execution.

Key Responsibilities

• Develop and execute comprehensive payer contracting strategies aligned with Retail Health business priorities growth objectives and evolving care delivery models.
• Assess evolving payer reimbursement and healthcare market trends and translate their implications into contracting strategies and recommendations.
• Serve as a strategic advisor to senior leadership providing insights and recommendations on payer strategy contracting opportunities risks and performance.
• Lead and develop a high-performing payer contracting team while establishing clear priorities accountability and consistent contracting practices.
• Lead complex payer negotiations renewals amendments and strategic contract discussions across national and regional health plans.
• Build and maintain senior-level payer relationships and identify opportunities to strengthen and expand those partnerships.
• Evaluate reimbursement terms contract economics financial opportunities and risks to inform negotiation strategies and business decisions.
• Oversee the payer contract portfolio establishing priorities and ensuring contracts deliver against financial operational and strategic objectives.
• Monitor contract performance and identify opportunities to improve reimbursement contract value and overall performance.
• Partner with Finance Legal Revenue Cycle Operations Clinical and Compliance to ensure effective contract development implementation and ongoing execution.
• Lead resolution of significant payer contracting issues disputes and escalations.

Required Qualifications

• 15 years of progressive healthcare experience including significant experience in payer or managed care contracting.
• Demonstrated success developing payer strategies leading complex healthcare contract negotiations and managing senior-level payer relationships.
• Strong understanding of healthcare reimbursement models contract economics payer-provider relationships and contract performance.
• Strong financial and analytical acumen with the ability to evaluate the business implications of complex contractual arrangements.
• Exceptional negotiation executive communication relationship management and influencing skills.
• Proven ability to lead across a complex highly matrixed healthcare organization and drive alignment among diverse stakeholders.
• Experience leading and developing high-performing teams.
• Deep experience with national and regional health plans and government and commercial payer contracting is highly valued particularly within ambulatory physician or retail health environments.
• Bachelors degree required; advanced degree preferred.

Pay Range

The typical pay range for this role is:

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 companys equity award program.

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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.

Additional details about available benefits are provided during the application process and on Benefits Moments.

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal state and local laws.