Executive Director, Payer Contracting - Retail Health
Listed on 2026-10-26
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Business
Regulatory Compliance Specialist, Operations Management -
Management
Regulatory Compliance Specialist, Operations Management
Executive Director, Payer Contracting – Retail Health
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 Executive Director, Payer Contracting leads payer contracting strategy for Retail Health, with responsibility for contract negotiations, payer relationships, financial performance, and contract execution. This leader will develop and advance payer strategies that support business growth, patient access, and sustainable financial performance while ensuring contractual arrangements align with the clinical and operational needs of the business.
The Executive Director serves as a key strategic partner across Finance, Legal, Operations, Revenue Cycle, Clinical, Compliance, and other enterprise stakeholders, bringing together payer strategy, financial insight, and operational execution.
Key Responsibilities
- Develop and execute comprehensive payer contracting strategies aligned with Retail Health business priorities, growth objectives, and evolving care delivery models.
- Assess evolving payer, reimbursement, and healthcare market trends and translate their implications into contracting strategies and recommendations.
- Serve as a strategic advisor to senior leadership, providing insights and recommendations on payer strategy, contracting opportunities, risks, and performance.
- Lead and develop a high-performing payer contracting team while establishing clear priorities, accountability, and consistent contracting practices.
- Lead complex payer negotiations, renewals, amendments, and strategic contract discussions across national and regional health plans.
- Build and maintain senior-level payer relationships and identify opportunities to strengthen and expand those partnerships.
- Evaluate reimbursement terms, contract economics, financial opportunities, and risks to inform negotiation strategies and business decisions.
- Oversee the payer contract portfolio, establishing priorities and ensuring contracts deliver against financial, operational, and strategic objectives.
- Monitor contract performance and identify opportunities to improve reimbursement, contract value, and overall performance.
- Partner with Finance, Legal, Revenue Cycle, Operations, Clinical, and Compliance to ensure effective contract development, implementation, and ongoing execution.
- Lead resolution of significant payer contracting issues, disputes, and escalations.
Required Qualifications
- 15+ years of progressive healthcare experience, including significant experience in payer or managed care contracting.
- Demonstrated success developing payer strategies, leading complex healthcare contract negotiations, and managing senior-level payer relationships.
- Strong understanding of healthcare reimbursement models, contract economics, payer-provider relationships, and contract performance.
- Strong financial and analytical acumen with the ability to evaluate the business implications of complex contractual arrangements.
- Exceptional negotiation, executive communication, relationship management, and influencing skills.
- Proven ability to lead across a complex, highly matrixed healthcare organization and drive alignment among diverse stakeholders.
- Experience leading and developing high-performing teams.
- Deep experience with national and regional health plans and government and commercial payer contracting is highly valued, particularly within ambulatory, physician,…
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