Ld Dir,Payer Relations

At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.

As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.

Director, Payer Relations

Position Summary

The Director, Payer Relations will oversee the Payer Relations function within our organization, ensuring the optimization of payer relationships which serve as primary revenue sources and access channels for our patients.  Leadership responsibilities will include performance measurement, process improvement, internal stakeholder management, and implementation of technology solutions to enhance the accuracy and efficiency of work.  This role will also take an active role in managing a portfolio of payers with responsibility for strategic contract negotiations, evaluating payer performance, resolving issues or disputes, and collaborating with internal and external stakeholders.

Location: Positions may sit anywhere in the country, but East Coast and/or near our Hub location preferred.

What you will do

Operational Optimization & Collaboration

• Drive continuous improvement by designing and implementing scalable processes and tools to support the efficient management of hundreds of payer relationships.
• Lead the adoption of technology solutions that enhance data accuracy, workflow efficiency, and contract lifecycle management.
• Provide strategic insights and recommendations to senior leadership to support enterprise-wide decision-making and performance optimization.

Relationship & Portfolio Management

• Actively manage a portfolio of payer relationships, serving as a key point of contact to resolve issues, negotiate terms, and foster collaboration.
• Oversee the execution of payer agreements in coordination with legal, finance, and operations, ensuring alignment with internal processes and timelines.
• Serve as a liaison to internal stakeholders, ensuring clear communication of payer terms and timely implementation of fee schedules and contract updates.

Strategic Direction & Payer Insight

• Lead the development and execution of payer strategy, including contract negotiations, reimbursement modeling, and alignment with organizational goals.
• Evaluate payer performance and identify opportunities for improvement in reimbursement accuracy, claims processing, and contract compliance.

Required Qualifications

• Demonstrated experience leading a payer or provider relations organization, including responsibility for developing and implementing the processes and tools to ensure efficient and successful management of these relationships.
• Adept at problem-solving within a large matrix organization and skilled in leveraging interpersonal relationships, critical thinking, and teamwork to solve complex problems.
• 10-years of experience with all aspects of provider contracting lifecycle – strategy, negotiation, contract drafting & redlines, implementation, and contract compliance.
• High-level understanding of claims, credentialing, and revenue cycle processes.
• Adept at execution and delivery (planning, delivering, and supporting) skills.
• Proficient in Microsoft Office Products, specifically Excel.

Education

• Bachelor's degree required

Pay Range

The typical pay range for this role is:

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 people

We 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/benefits

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