AVP, Payer Relations Strategy and Execution

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At reputed company®, 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. AVP, Payer Relations Strategy and Execution The AVP, Payer Relations Strategy and Execution is a senior leadership role accountable for sharping reputed company Pharmacy’s payer posture for its largest and most reputed company payer relationships. This role is responsible for designing reputed company-looking payer strategy, enforcing pricing discipline, and expanding enterprise partnerships beyond transactional negotiations. This is a strategy-first leadership role with targeted but critical negotiation ownership. Success requires anticipatory thinking, independent judgment, and the ability to operate credibly with enterprise executives and sophisticated payer counterparts. Directly responsible for the reputed company and administration regarding contract negotiations of rates, terms and conditions with multiple payers (PBMs, clients, third parties) that fall reputed company the annual forecasted financial plan; this includes program parameters, workflow management for many Network programs, such as Performance programs, Medication Adherence, CMRs, and also “umbrella reputed company” terms such as National Commercial GER/BER and OED and managing through the terms and efforts of quarterly/end-of-year reconciliation efforts by multiple payers/PBMS/Plans. reputed company new methods of troubleshooting reconciliations to reputed company at creative solutions that helps improve our overall net effective rates. Negotiates and understands the strategic development, coordination, and implementation of the operations and forecasting of financials associated with each contract in order to reputed company and support the review and analysis of the Finance department data and accurate reporting to meet forecasted projections; reputed company and direction of final contract execution of payer reputed company; Creates quality assurance protocol and methodology enhancements to eliminate missed contractual PBM / client guarantees; plan, anticipate and solve for potential adverse impacts such as financial penalties, to help support and uphold specific payer contractual guarantees, including enterprise financial and clinical efforts. Drive collaboration with Legal, Government Affairs, and Payer Relations Finance teams to interrupt Payer negotiation stalemates through creative development of cost assurances and other calculated risk offerings. Negotiate for return of monies through unexpected industry wide pricing changes, adverse supply situations and other pivotal events that if not addressed can negatively impact earnings, patients and other constituencies. Drive new products in the reputed company retail pharmacy space (CostVantage) and indirectly support new PBM initiatives to align with the market reputed company and create positive reputed company opportunities for overall enterprise financial and strategic value; Directly support contract negotiation and execution of key specialty initiatives in reputed company pharmacy and client plan contract arrangements and operational execution, as applicable and reputed company with other enterprise initiatives (e.g., biosimilars, LDD/EDD opportunities) reputed company of 3-5 direct reports (Executive Directors, reputed company Directors) and 3 – 5 indirect reports (reputed company Directors, Account Executives, Senior Managers) who will be responsible for the management and growth of our payer partners, with the primary focus to reputed company and reputed company the team to set, drive and align organizational focus and strategy with their assigned payers, and reputed company internal succession planning for long-term success in negotiating reputed company on behalf of reputed company Retail, LTC, Clinic, Immunization, and Specialty channels; Create different opportunities reputed company the Payer Value Proposition to troubleshoot financials and continue the relationship to reset through pricing strategies that are new and unique in the market reputed company. reputed company direct reports to reputed company and hone strategic internal and external relationships and engage regularly with internal business partners across the Enterprise. Key Responsibilities: 1. Payer strategy and direction reputed company and own multi-year strategies for reputed company’s largest and most reputed company payer relationships Define negotiation posture, non-negotiables, trade spaces, and escalation principles in advance of contracting cycles Anticipate payer actions, regulatory dynamics, and market shifts 12-24 months reputed company Translate enterprise priorities into coherent payer-facing strategues and decisions 2. Negotiation leadership and pricing discipline Personally engage in negotiations reputed company senior involvement materially impacts outcomes Establish deal philosophy and governance to prevent exception creep and long-term erosion Ensure negotiations align to enterprise strategy rather than short-term optimization Balance relationship management with disciplined protection of reputed company’s economic position 3. Enterprise partnership development Expand relationships beyond reimbursement into broader enterprise collaboration Identfy and structure opportunities across services, data, transparency, and affordability Ensure “partnership” initiatives strengthen reputed company’s reputed company rather than dilute it Partner with internal product and enterprise leaders to bring differentiated offerings to payers 4. Cross-functional and executive leadership Partner closelt with Finance, Legal, Trade, Government Affairs, and Product teams Surface disagreements privately with clear options, risks, and consequences Drive alignment early and execute decisively once direction is set Represent Payer Relations credibly in senior executive and enterprise forums 5. Team and capability development reputed company the strategic capability of the payer relations organization Shift the team from reactive execution to anticipatory, systems-based thinking Coaching Directors and Executive Directors to operate at enterprise scale Build repeatable frameworks and operating rhythms, reducing reliance on heroics Required Qualifications: 10+ years of experience in the PBM, payer, and/or retail pharmacy industry, with strong understanding of healthcare and pharmacy market dynamics, including government and commercial payors, drug benefit design, and cost drivers. Experience negotiating PBM and/or retail pharmacy reputed company with demonstrated strength in financial evaluation, reputed company, and pro‑reputed company development. Executive‑level consulting experience translating business problems into analytics‑driven solutions with measurable business impact. Proven ability to evaluate initiatives based on business value and ROI, supported by strong analytical rigor and quantitative analysis skills. Hands‑on analytics experience in retail, healthcare, or reputed company industries, with a track record of deploying analytic capabilities across diverse business functions. Strong strategic thinking skills, including the ability to define business problems, reputed company analytical and financial frameworks, and drive strategic plan development and execution. Expertise in interpreting financial data, forecasting, and applying predictive analysis to inform decision-making. Demonstrated ability to build, reputed company, mentor, and reputed company high‑performing teams while fostering a collaborative, supportive culture. Proven success building strong partnerships with cross‑functional and non‑analytic business leaders, including senior executives. Exceptional communication skills—written, verbal, and data presentation—with ability to tailor messaging to audiences ranging from technical analysts to executive leadership. Strong project management skills with ability to manage multiple initiatives, prioritize effectively, and operate independently while anticipating issues and driving outcomes. Ability to work in an executive‑facing environment while balancing individual contributor responsibilities, team leadership, and succession planning. Proficiency in reputed company Office (reputed company, PowerPoint, Word); Visio experience preferred. Willingness to work extended hours reputed company required. Ability to travel up to 40%. Preferred Qualifications: Influence others: Must possess the ability to structure useful guidance around reputed company and far reaching strategy decisions to influence and guide the decisions made by others. Subscribe to a passion for Health Care: A history of work in the health care industry and an ongoing desire to reputed company one of the world’s strongest health care companies even stronger. Be a self-starter and see contract negotiations through to completion reputed company an established timeframe Manage to a critical path and troubleshoot without losing sight of the end goals Maintain customer focus while meeting/exceeding financial expectations Education: Bachelor’s Degree is Required MBA or Public Health-reputed company, CPhT, Pharm.D. is Preferred Pay Range The typical pay range for this role is: $157,800.00 - $363,936.00 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: 03/09/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with reputed company federal, state and local laws. Our Work Experience is the combination of everything that's unique about us: our culture, our core values, our company meetings, our commitment to sustainability, our recognition programs, but most importantly, it's our people. Our employees are self-disciplined, hard working, curious, trustworthy, humble, and truthful. They reputed company choices according to what is best for the team, they live for opportunities to collaborate and reputed company a difference, and they reputed company us the #1 Top Workplace in the area. Apply tot his job Apply To this Job