Lead Director - Medical Pharmacy Network

CVS Health

7d•$100,000 - $231,540

About The Position

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary Drives network strategy and performance improvement for medical drug reimbursement across hospital, health system, and regional provider partners. Enables market teams with contracting guidance, analytics, and best practices to improve cost, quality, and access outcomes.

Requirements

At least 10 years of experience in health plan operations, network contracting, or provider-facing contracting environments.
At least 3 years of experience in a health plan setting, with exposure to payer operations and healthcare administration.
Demonstrated ability to translate complex contracting, financial, and operational information into concise, executive-level narratives that drive informed decision-making, align stakeholders, and communicate business value effectively.
Proven ability to critically evaluate contract terms, reimbursement structures, and business proposals, confidently challenging unfavorable provisions and advocating for solutions that mitigate risk, protect organizational interests, and support long-term strategic objectives.
Demonstrated knowledge of medical pharmacy reimbursement and outpatient reimbursement models, including payer and provider considerations.

Nice To Haves

Experience with health system and hospital network contracts.
Contracting experience with infusion, medical pharmacy arrangements, and/or value-based care.

Responsibilities

Develop Market Network contract relationships providing support for market agreements/negotiations with health systems, hospitals and regional provider groups.
Align broader medical pharmacy strategy with National Ancillary Network & Value-Based Care teams.
Designs strategic retail network initiatives and plans by analyzing market trends, assessing competitive advantages, and identifying opportunities to grow the network's effectiveness and efficiency.
Defines programs to ensure alignment and integration of the provider network strategy with overall business objectives, collaborating with operations, marketing, and finance.
Controls all systems that monitor the performance of the medical pharmacy / infusion provider network, subsequently analyzing key performance indicators and identifying specific areas for improvement.
Communicates with external stakeholders, including healthcare organizations and insurance providers, to establish partnerships and collaborative arrangements.
Aligns retail provider network strategies with legal and regulatory frameworks, ensuring critical compliance with all relevant health regulations and standards.
Advises senior management and stakeholders on provider network performance, patient expectations and outcomes, and key financial metrics and targets.
Designs key strategies for retail network performance and partners with market leaders to ensure business plan requirements and team objectives are consistently met.