Lead Director, Payer Relations

Job not on LinkedIn

🕒 2 days ago

⚓ Rhode Island – Remote

⚓ Rhode Island – Remote

💵 $100k - $231.5k / year

⏰ Full Time

🟠 Senior

👔 Director

👻 Ghost score 0%

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CVS Health

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1963

🏥 Healthcare

⚕️ Healthcare Insurance

🛒 Retail

Healthcare • Healthcare Insurance • Retail

CVS Health is a leading American healthcare company dedicated to improving health access and affordability. The company focuses on a comprehensive approach that includes health services, health insurance, and pharmacy benefits management. Through its subsidiaries, such as Aetna and CVS Caremark, CVS Health offers a range of services that facilitate wellness, condition management, and affordable prescription drug coverage. CVS Health operates neighborhood pharmacies, provides mail-order pharmacy services, and manages specialty medication programs, aiming to make healthcare convenient and accessible for everyone. Driven by a mission to connect people with essential care services, CVS Health is committed to fostering healthier communities and supporting the wellbeing of all individuals.

📋 Description

• Lead contract negotiations and manage an assigned portfolio of payer relationships, ensuring favorable rates, terms, and business outcomes • Develop and execute negotiation strategies supporting financial, operational, and market-share objectives • Monitor portfolio performance, identify risks and opportunities, and recommend actions to improve profitability and growth • Build and maintain executive-level relationships with payer organizations • Collaborate with internal partners across Finance, Legal, Operations, Analytics, and Government Affairs • Coach and develop team members • Contribute to negotiation best practices, talent development, and organizational capability building

🎯 Requirements

• 10+ years of experience in payer relations, pharmacy benefit management, retail pharmacy, healthcare contracting, or a related healthcare field • 5+ years of experience negotiating contracts and managing associated financial terms and performance outcomes • Experience managing a portfolio, book of business, or commercial relationships with accountability for revenue, profitability, or market share results • Experience presenting, negotiating, and influencing executive-level stakeholders • Strong analytical and strategic problem-solving skills with the ability to evaluate complex business and financial scenarios • Experience negotiating directly with national PBMs, health plans, or large healthcare payers preferred • Knowledge of Medicare Part D, Medicaid, and commercial pharmacy network reimbursement models preferred • Experience leading, coaching, or developing contract negotiators or payer relations professionals preferred • Experience creating negotiation frameworks, governance processes, or contracting best practices preferred • Bachelor's degree required, or equivalent combination of education and relevant work experience • Master's degree preferred • Advanced degree such as MBA, PharmD, JD, or related graduate-level education preferred • Up to 25% travel required

🏖️ Benefits

• CVS Health bonus, commission or short-term incentive program • 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