Lead Director, National Health Systems Contracting

cutive Director for negotiations with the national health systems.

• Supports Senior Manager, Network Management to load complex hospital contracts accurately and timely.
• Assesses provider performance metrics, such as utilization rates, patient satisfaction scores, and claims data to identify areas for improvement and cost containment.
• Collaborates with providers to implement initiatives that optimize quality and efficiency of services.
• Provides assistance and support to other departments, as needed, to obtain crucial or required information from providers, such as HEDIS, Credentialing, etc.
• Leads work and deliverables of complex projects/programs, through assessment to implementation, that may impact multiple processes, systems, functions, and products across all lines of business.
• Excellent analytical and problem-solving skills
• Strong communication, negotiation, and presentation skills
• Ability to work in a matrixed organization and gain consensus and share information to various interested parties.

Required Qualifications

• A minimum of 7 years of related experience and comprehensive level of negotiating skills with successful track record negotiating contracts with large complex provider systems or groups, hospitals and large physician and risk bearing entities
• A minimum of 5 years of related experience reviewing medical claims data and developing executive summaries and identifying opportunities for mitigating medical cost trend
• Familiar with legal terms in the context of provider contracting and contracting management systems.

Preferred Qualifications

• Familiar with CMS Stars and HEDIS technical specifications and various measurable percentiles associated with the HEDIS measures.

• Experience with Commercial, Medicare, and Individual Medicaid contracting.

• Strong financial modeling background.

Education

• Bachelor Degree preferred or a combination of professional work experience and education.

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: 02/28/2026Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.