Ld Dir,Payer Relations

llaborates with key stakeholders to drive network growth and ensure high-quality provider relationships.

What you will do

• Execute provider participation agreements for MinuteClinic's for all assigned states and payers

• Develops a strategy and vision for managing relationships and interactions with various healthcare payers related to payer contracting.

• Establishes agreements on reimbursement rates, formulary placement, and other contractual terms for prescription medications and healthcare services.

• Builds and maintains strong relationships with payer organizations to understand organizational needs, address concerns, and foster collaborative partnerships.

• Analyzes market trends, identifies growth opportunities, and aligns health services and offerings with payer requirements.

• Ensures that contractual obligations are met and resolves any issues related to the administration and compliance of payer contracts.

• Develops, analyzes, and monitors performance metrics of payor contracts and shares insights, coordinates efforts, and drives cross-functional initiatives.

• Stays up to date with the evolving healthcare industry landscape and changes in payer policies, regulations, and market dynamics to effectively respond to industry shifts.

• Collaborates with the internal team to align payer strategies with overall business objectives.

• Communicates complex Payer concepts and strategies to senior management, clients, and regulatory bodies.

Preferred Qualifications

• 10+ years work experience

• Experience representing providers in payer negotiations for commercial plans along with governmental plans

• Experience with value-based contracting

• Fee schedule development, maintenance and interpretation

• Proficient with contract rate analysis and working with payer analytics

• Strong Microsoft Office skills, primarily Excel and PowerPoint

• Prior experience leading managed care contracting team

Education

• Bachelor's degree preferred.

Pay Range

The typical pay range for this role is:$100,000.00 - $231,540.00

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. This position also includes an award target in the company's equity award program.Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.Great benefits for great peopleWe take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:

• Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
• Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.

For more information, visit https://jobs.cvshealth.com/us/en/benefitsWe anticipate the application window for this opening will close on: 07/04/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.