Lead Director, Payer Relations
Remote · USFull-time$100–232K/yrPosted 2 days agoStill listed 1 day ago
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Job overview
The Lead Director, Payer Relations leads strategic relationships and contract negotiations with PBMs, health plans, insurance carriers and Medicaid programs, driving financial performance, network positioning and business growth through effective negotiation, relationship management and commercial strategy.
Skills & qualifications
Skills
Qualifications
Benefits
Full job description
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 Lead Director, Payer Relations is responsible for leading strategic relationships and contract negotiations with pharmacy benefit managers (PBMs), health plans, insurance carriers, Medicaid programs, and other payer organizations. This role drives financial performance, network positioning, and long-term business growth through effective negotiation, relationship management, and commercial strategy. The ideal candidate is an experienced healthcare leader with deep expertise in payer contracting, financial accountability, and executive-level stakeholder engagement.
What You'll Gain
- Opportunity to influence enterprise-wide payer strategy and financial outcomes
- Exposure to senior healthcare executives and industry-leading payer organizations
- Ability to mentor and develop future payer relations leaders
Roles & Responsibilities
- Lead contract negotiations and manage an assigned portfolio of payer relationships, ensuring favorable rates, terms, and business outcomes.
- Develop and execute negotiation strategies that support financial, operational, and market-share objectives.
- Monitor portfolio performance, identify risks and opportunities, and recommend actions to improve profitability and growth.
- Build and maintain executive-level relationships with payer organizations and collaborate with internal partners across Finance, Legal, Operations, Analytics, and Government Affairs.
- Coach and develop team members while contributing to negotiation best practices, talent development, and organizational capability building.
Travel: Up to 25% travel required
Required Qualifications
- 10+ years of experience in payer relations, pharmacy benefit management, retail pharmacy, healthcare contracting, or a related healthcare field.
- 5+ years of experience negotiating contracts and managing associated financial terms and performance outcomes.
- Demonstrated experience managing a portfolio, book of business, or commercial relationships with accountability for revenue, profitability, or market share results.
- Experience presenting, negotiating, and influencing executive-level stakeholders.
- Strong analytical and strategic problem-solving skills with the ability to evaluate complex business and financial scenarios.
Preferred Qualifications
- Experience negotiating directly with national PBMs, health plans, or large healthcare payers.
- Knowledge of Medicare Part D, Medicaid, and commercial pharmacy network reimbursement models.
- Experience leading, coaching, or developing contract negotiators or payer relations professionals.
- Experience creating negotiation frameworks, governance processes, or contracting best practices.
- Advanced degree such as MBA, PharmD, JD, or related graduate-level education.
Education
- Bachelor's degree required, or equivalent combination of education and relevant work experience.
- Master'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 people
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. Additional details about available benefits are provided during the application process and on Benefits Moments.
We anticipate the application window for this opening will close on: 10/09/2026
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
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