Lead Director, Payer Relations

CVS Health•Woonsocket, RI

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 The Lead Director, Payer Relations is responsible for leading strategic relationships and contract negotiations with pharmacy benefit managers (PBMs), health plans, insurance carriers, Medicaid programs, and other payer organizations. This role drives financial performance, network positioning, and long-term business growth through effective negotiation, relationship management, and commercial strategy. The ideal candidate is an experienced healthcare leader with deep expertise in payer contracting, financial accountability, and executive-level stakeholder engagement.

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.
Demonstrated 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.
Bachelor's degree required, or equivalent combination of education and relevant work experience.

Nice To Haves

Experience negotiating directly with national PBMs, 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.
Advanced degree such as MBA, PharmD, JD, or related graduate-level education.
Master's degree preferred.

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.