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CVS Health

Runs pharmacies, health plans and clinics

Lead Director - Payer Relations

Account ManagementPosted on Nov 11
Full-timeRhode Island, USA

About the Job

Requirements

  • At least 10 years of experience in payer relations, pharmacy benefit management, retail pharmacy, healthcare contracting, or a related healthcare field.
  • At least 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, including the ability to evaluate complex business and financial scenarios.
  • A bachelor's degree or an equivalent combination of education and relevant work experience is required.

Responsibilities

  • Lead contract negotiations and manage an assigned portfolio of payer relationships, ensuring favorable rates, terms, and business outcomes.
  • Develop and execute negotiation strategies that support 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 and collaborate with internal partners across Finance, Legal, Operations, Analytics, and Government Affairs.
  • Coach and develop team members while contributing to negotiation best practices, talent development, and organizational capability building.
  • Travel up to 25%.

Desired Qualifications

  • Experience negotiating directly with national pharmacy benefit managers, health plans, or large healthcare payers.
  • Knowledge of Medicare Part D, Medicaid, and commercial pharmacy network reimbursement models.
  • Experience leading, coaching, or developing contract negotiators or payer relations professionals.
  • Experience creating negotiation frameworks, governance processes, or contracting best practices.
  • An advanced degree such as an MBA, PharmD, JD, or related graduate-level education; a master's degree is preferred.

About the Company

CVS Health

Runs pharmacies, health plans and clinics

CVS Health runs pharmacies, health insurance plans and medical clinics for individuals, employers and government programs across the United States. Its businesses include CVS Pharmacy, the Aetna insurer and Caremark, which manages prescription coverage and negotiates drug prices for health plans. Patients fill prescriptions in stores or by mail and receive care through walk-in clinics, primary care centers and home visits. The company earns money from prescription sales, insurance premiums, plan administration fees and clinical services, combining coverage with places to obtain treatment. Its first store opened in 1963, and its headquarters are in Woonsocket, Rhode Island.

Company size
10,001+
Company stage
IPO
Headquarters
Woonsocket, Rhode Island
Founded
1963

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