Executive Director, Payer Relations Strategy Enablement & Operations
CVSHealth
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 key member of the Payer Relations leadership team, responsible for shaping how payer strategy decisions are enabled, governed, and executed across CVS Health. With CVS CostVantage® established as the baseline reimbursement model, this role focuses on what comes next—ensuring payer decision frameworks, systems, and operating models continuously evolve in response to regulatory change, market dynamics, and enterprise priorities.
This role is not focused on transactional execution or single‑initiative rollouts. Instead, it owns the strategy enablement and decision infrastructure that empowers payer teams to operate with greater speed, consistency, and confidence—transitioning the organization away from manual, one‑off analyses toward standardized, automated, and increasingly AI‑enabled operating models.
Key Responsibilities:
- Own, design, and continuously evolve enterprise decision frameworks, governance models, and operating rhythms supporting payer strategy and contracting.
- Lead the development and adoption of automation, systems, and AI‑enabled decision infrastructure that improves speed, scalability, and consistency.
- Ensure CVS CostVantage® remains the foundational reimbursement model while adapting decision logic to regulatory, market, and payer‑specific changes.
- 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 narratives and recommendations.
- Drive change management and adoption across payer teams to embed new ways of working into day‑to‑day operations.
Required Qualifications:
- 15+ years of progressive leadership experience within healthcare, payer strategy, pharmacy, or related regulated environments.
- 10+ years leading large‑scale, cross‑functional, enterprise initiatives with measurable business impact.
- Demonstrated experience transitioning organizations from manual, analyst‑driven processes to automated, system‑enabled, and scalable operating models.
- Strong financial acumen with deep understanding of payer economics, reimbursement models, and trade‑offs across pricing, margin, and access.
- Proven ability to design and enable decision frameworks that balance governance, speed, and strategic flexibility.
- Strong orientation toward automation, systems thinking, and emerging AI‑enabled capabilities.
- Exceptional executive communication, storytelling, and influence skills, with experience presenting complex topics to senior leadership.
- Demonstrated ability to lead through influence in a highly matrixed, cross‑functional enterprise environment.
- Strong problem‑solving, organizational, and change‑leadership capabilities.
- Ability to travel up to 20%.
Preferred Qualifications:
- Prior Executive Director–level experience within a large, complex enterprise (Fortune 100–scale or equivalent).
- Experience leading strategy enablement, transformation, or operating model design within payer, provider, PBM, or life sciences organizations.
- Proven track record of driving enterprise change through governance, standardization, and system‑based solutions rather than incremental process fixes.
- Experience partnering closely with executive leadership 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 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
We anticipate the application window for this opening will close on: 04/20/2026Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.