Executive Director, Payer Contracting - Retail Health
About The Position
The Executive Director, Payer Contracting leads payer contracting strategy for Retail Health, including 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 the business’s clinical and operational needs. The Executive Director is a strategic partner to Finance, Legal, Operations, Revenue Cycle, Clinical, Compliance, and other enterprise stakeholders, connecting payer strategy, financial insight, and operational execution. The role advises senior leadership, leads and develops a high-performing contracting team, manages the payer contract portfolio, and oversees contract performance and resolution of significant contracting issues.
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 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 align 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, particularly within 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 payer negotiations, renewals, amendments, and strategic contract 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 negotiations and business decisions.
- Oversee the payer contract portfolio, prioritize work, and 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 execution.
- Lead resolution of significant payer contracting issues, disputes, and escalations.
Benefits
- Medical coverage
- Dental coverage
- Vision coverage
- Paid time off
- Retirement savings options
- Wellness programs
- Other resources, based on eligibility
- CVS Health bonus, commission, or short-term incentive program
- Company equity award program
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What This Job Offers
Job Type
Full-time
Career Level
Executive
