Executive Director, Medicare Revenue Management

Executive Director Of Medicare Revenue Management

This role serves as the single financial owner of Medicare Revenue for Medicare Advantage and Medicare Part D, accountable for the end-to-end translation of member acuity, program policy changes, corporate revenue-focused initiatives, and risk adjustment outcomes into forecasted and booked revenue. The role aligns directly to Finance accountability for forecasts, accruals, and earnings explainability and is designed to strengthen accuracy, transparency, and decision discipline when estimating revenue outcomes.

The Executive Director of Medicare Revenue Management partners closely with Revenue Integrity (RI), Actuarial, and Product Finance but owns the financial modeling, projections, accruals, and variance explanations reflected in forecast, close, and executive reporting.

• Own end-to-end revenue modeling and forecasting
• Lead accrual development and revenue recognition
• Strengthen accuracy and explainability
• Partner with key internal stakeholders
• Deliver executive-ready insights and governance
• Team & leadership expectations

• 10+ years of experience in healthcare finance, actuarial, or advanced analytics.
• Expertise in Medicare Advantage and Part D risk adjustment economics and CMS payment mechanics/timing.
• Demonstrated ownership of forecasts, accruals, and financial explainability.
• Experience translating complex analytics into executive-level insights.
• Proven ability to lead high-performing, cross-functional teams.

• Actuarial credentials (ASA/FSA), advanced quantitative degrees (e.g., MS in Statistics, Data Science, or Health Economics), or other credentials demonstrating strong analytical and healthcare reimbursement expertise.
• Experience supporting Medicare bids or CMS-related financial processes.
• Experience leading or scaling analytical capabilities within Finance.

Bachelor's Degree

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.

We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. This full-time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well-being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.

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