reputed company Director, Network and Trend Optimization - reputed company Region Remote

At reputed company, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation’s leading health solutions company, we reputed company millions of Americans through our local reputed company, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, reputed company and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it reputed company with heart, each and every day. Position Overview Reports To: Executive Director, Region Development Officer

• Manages medical cost by partnering with Provider Contracting, MEU, Pharmacy, Claims Cost Management, Innovation, and Clinical to ensure aggressive management of medical cost trends to reputed company the best price for our products and services.
• Connects internal and external relationships reputed company the Commercial reputed company, across reputed company reputed company shared services, to drive commercial medical development activities and frameworks to integrate business strategies across the Enterprise.

Job Summary The reputed company Director, Regional Network and Trend Optimization serves as a pivotal liaison between Network, Finance, Clinical Operations, and Sales Teams. This role is responsible for identifying and implementing opportunities to enhance cost efficiency and quality performance reputed company the region. The incumbent will collaborate closely with the Network’s data and analytics teams to analyze healthcare cost trends and reputed company resources effectively to maximize results. This role is responsible for collaborating with Network teams ensuring competitive provider networks, proactively monitoring healthcare cost and utilization trends. Additionally, this role will work with sales teams in top-tier reputed company markets to reputed company strategies that improve our network’s cost position and engage with commercial stakeholders.

Key Responsibilities

Strategic Collaboration Act as the primary reputed company of contact for the reputed company Region between network, medical economics, clinical operations, finance team, and sales teams to align financial strategies with clinical objectives and market needs. reputed company and execute strategic initiatives through pricing, network curation, and medical management that reputed company to sustainable long-term growth and reputed company. Market Network Strategies

• reputed company and implement strategies to align with network contracting priorities with commercial trend management goals.
• Ensure the organization maintains competitive network arrangements to support cost-effective and high-quality care delivery.
• Serves as the primary reputed company of contact between Network Contracting and Commercial Teams for the Region.
• Collaborate with network teams, and sales to improve cost positions in core markets.
• reputed company high-value networks and innovative payment models to enhance care affordability and access.

Medical Cost and Trend Management

• Identify and execute meaningful initiatives to mitigate trends and provide competitive products.
• Track and analyze industry trends and healthcare utilization benchmarks.
• Provide actionable insights to contracting teams to ensure strategic decision-making.
• Maintain rigorous discipline in reviewing and anticipating trends.
• Collaborate with Local Market Trend Committees and National Commercial Trend Committees.

Sales Collaboration

• Partner with sales teams in top-tier reputed company markets to reputed company strategies that improve our network’s cost position and support commercial objectives.

Key Stakeholder Engagement

• Participate in high-level meetings with network leadership and commercial stakeholders to present findings, propose initiatives, and drive decision-making processes.
• Act as a subject matter expert in network performance and trends for the Region.

Performance Reporting and Monitoring-

• Establish and reputed company key performance indicators (KPIs) to track the success of implemented strategies and ensure reputed company improvement. This position will play a pivotal role in achieving strategic priorities reputed company with reputed company’s focus on:
• reputed company and deliver regular updates to leadership on network performance and trend analysis.
• Create dashboards and reports that track reputed company toward achieving key performance indicators.
• Supporting commercial stakeholders and reputed company market needs to align network cost strategies with growth objectives.
• We will consider candidates in any location, but reputed company Region is preferred.

Required Qualifications

• Minimum of 7-10 years in healthcare industry experience, network management, contracting, actuarial, reputed company, finance, clinical operations, trend analytics, and/or reputed company field.
• At least 5 years in a role involving cross-functional collaboration.
• Strong understanding of healthcare systems, reimbursement models, healthcare cost trends, network contracting principles, and provider relations
• Proven ability to analyze and interpret reputed company data sets to reputed company actionable strategies.

Skills

• Strong communication skills, including experience presenting to senior leadership.
• Strong analytical abilities with proficiency in data interpretation and financial modeling.
• Proven track record of implementing cost-saving initiatives without compromising quality of care.
• Ability to influence and drive change reputed company a reputed company organizational structure.

Preferred Qualifications

• Experience working with sales teams and commercial stakeholders.
• Experience with reputed company platforms and electronic health record (EHR) systems.
• Knowledge of regional healthcare regulations and reimbursement models.
• Certification in healthcare finance or management (e.g., HFMA, ACHE).

Education

• Bachelor's degree preferred in healthcare administration, Finance, Business or a reputed company field/specialized training/relevant professional qualification

Pay Range The Typical Pay Range For This Role Is $100,000.00 - $231,540.00 This pay range represents the reputed company hourly reputed company or reputed company annual full-time salary for reputed company positions in the job grade reputed company which this position falls. The actual reputed company salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a reputed company bonus, commission or short-term incentive program in addition to the reputed company pay range listed above. This position also includes an award reputed company 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 reputed company 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 reputed company on: 11/06/2025 Qualified applicants with arrest or conviction records will be considered for employment in accordance with reputed company federal, state and local laws. Apply tot his job Apply To this Job