Executive Director, Payer Contracting - Retail Health
About The Position
The Executive Director, Payer Contracting leads payer contracting strategy for Retail Health, overseeing contract negotiations, payer relationships, financial performance, and contract execution. The role develops and advances payer strategies that support business growth, patient access, and sustainable financial performance while aligning contractual arrangements with clinical and operational needs. This leader serves as a strategic partner to Finance, Legal, Operations, Revenue Cycle, Clinical, Compliance, and other enterprise stakeholders, integrating payer strategy, financial insight, and operational execution. The position leads a payer contracting team, manages the payer contract portfolio, advises senior leadership, and drives effective contract development, implementation, performance, and issue resolution.
Requirements
- 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, including the ability to evaluate complex contractual arrangements and their business implications.
- Exceptional negotiation, executive communication, relationship management, and influencing skills.
- Ability to lead across a complex, highly matrixed healthcare organization and drive alignment among diverse stakeholders.
- Experience leading and developing high-performing teams.
- Bachelor’s degree required.
Nice To Haves
- Deep experience with national and regional health plans and government and commercial payer contracting is highly valued, particularly in ambulatory, physician, or retail health environments.
- Advanced degree preferred.
Responsibilities
- Develop and execute payer contracting strategies aligned with Retail Health priorities, growth objectives, and evolving care delivery models.
- Assess payer, reimbursement, and healthcare market trends and translate their implications into contracting strategies and recommendations.
- Advise senior leadership on payer strategy, contracting opportunities, risks, and performance.
- Lead and develop a high-performing payer contracting team, setting priorities, accountability, and consistent contracting practices.
- Lead complex negotiations, renewals, amendments, and strategic discussions with national and regional health plans.
- Build and maintain senior-level payer relationships and identify opportunities to strengthen and expand partnerships.
- Evaluate reimbursement terms, contract economics, financial opportunities, and risks to inform negotiation strategies and business decisions.
- Oversee the payer contract portfolio and establish priorities to ensure contracts meet 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 on contract development, implementation, and ongoing execution.
- Lead resolution of significant payer contracting issues, disputes, and escalations.
Benefits
- Medical, dental, and vision coverage
- Paid time off
- Retirement savings options
- Wellness programs
- Other resources supporting colleagues’ physical, emotional, and financial well-being, based on eligibility
- Eligible for a CVS Health bonus, commission, or short-term incentive program
- Equity award program
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What This Job Offers
Job Type
Full-time
Career Level
Executive
