Executive Director, Payer Relations Strategy Enablement & Operations

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 Relations Strategy Enablement & Operations is a senior leader within the Payer Relations organization, accountable for building and owning the enterprise infrastructure that governs how CVS Health prepares for and executes payer negotiations.

With CVS CostVantage® established as the foundational reimbursement model, this role focuses on what comes next—designing and continuously evolving the decision frameworks, systems, governance, and operating models that enable consistent, high‑quality payer deal execution across the portfolio.

This role owns the end‑to‑end negotiation enablement lifecycle, including deal preparation standards, counterparty strategy, negotiation playbooks, capability development, and post‑deal learning. It is deliberately not focused on transactional execution; instead, it defines how payer teams operate—transitioning CVS from manual, one‑off analyses toward standardized, automated, and increasingly AI‑enabled decision and negotiation models that scale with enterprise complexity.

Key Responsibilities:

Strategy Enablement & Decision Infrastructure

• Own, design, and continuously evolve enterprise decision frameworks, governance models, and operating rhythms supporting payer strategy and contracting.
• Ensure CVS CostVantage® remains the baseline reimbursement model while adapting decision logic to regulatory, market, and payer‑specific dynamics.
• Enable strategic initiatives through scalable tools, standardized processes, and repeatable decision models rather than siloed analyses.
• Integrate complex cross‑functional inputs (finance, legal, actuarial, analytics, operations) into clear, executive‑ready recommendations.
• Lead change management and adoption to embed new operating models into day‑to‑day payer team workflows.

Negotiation Enablement & Deal Lifecycle Ownership

• Own the end‑to‑end negotiation preparation infrastructure, ensuring AVPs and PRDs enter negotiations with clear deal strategy, counterparty intelligence, and behavioral frameworks.
• Build and maintain payer‑segment negotiation playbooks aligned to current market dynamics and CVS’ strategic positioning.
• Lead the counterparty intelligence function, including economic modeling, network inclusion/exclusion analyses, and leverage assessments that directly inform negotiation strategy.
• Design and run structured after‑action review processes that convert deal experience into institutional learning and continuous playbook refinement.
• Develop negotiation capability across payer leadership through standardized curriculum, coaching, and deal preparation support.

Systems, Automation & AI Enablement

• Lead the development and adoption of automated, system‑enabled, and AI‑assisted decision infrastructure to improve speed, scalability, and consistency.
• Transition the organization from analyst‑dependent, manual processes to durable, enterprise‑grade operating capabilities.

Required Qualifications:

• 15+ years of progressive leadership experience within healthcare, payer strategy, pharmacy, or similarly regulated environments.
• 10+ years leading large‑scale, cross‑functional enterprise initiatives with measurable business impact.
• Direct experience with payer contract negotiations or building negotiation infrastructure within a payer, PBM, pharmacy, or provider organization.
• Demonstrated fluency in PBM and payer economics, including network inclusion/exclusion dynamics, counterparty decision modeling, reimbursement mechanics, and Medicare Part D.
• Proven track record building durable organizational negotiation capability (e.g., playbooks, deal preparation standards, governance, or equivalent frameworks).
• Experience transitioning organizations from manual, analyst‑driven work to automated, system‑enabled operating models.
• Strong financial acumen with the ability to assess tradeoffs across pricing, margin, access, and strategic positioning.
• Demonstrated ability to design decision frameworks that balance governance, speed, and strategic flexibility.
• Exceptional executive communication, storytelling, and influence skills in highly matrixed environments.
• Strong change leadership, problem‑solving, and organizational effectiveness capabilities.
• Ability to travel up to 20%.

Preferred Qualifications:

• Prior Executive Director–level experience within a large, complex enterprise (Fortune 100 or equivalent scale).
• Experience leading strategy enablement, operating model design, or transformation within payer, provider, PBM, or life sciences organizations.
• Proven success driving enterprise change through governance, standardization, and system‑based solutions rather than incremental process improvements.
• Experience partnering closely with senior executives to translate strategy into durable operating capabilities.

Education:

• Bachelor’s degree required

Pay Range

The typical pay range for this role is:

$131,500.00 - $303,195.00

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: 04/27/2026

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