CVS Health · 2 months ago
Executive Director, Network Management - Keystone Territory
United States
Full-time
Remote
Director/Executive
$132K/yr - $303K/yr
10+ years expCVS Health is the nation’s leading health solutions company, dedicated to transforming health care. The Executive Director, Network Management will provide strategic leadership and oversight for network management and provider relations, focusing on developing network strategies and managing provider contracts to ensure high-quality provider relationships.
Health CareMedicalPharmaceuticalRetailSales
Responsibilities
Overseeing key network management contracting activities, including negotiating fee schedules, reimbursement rates, and contract terms and conditions
Controlling the development and expansion of the company's provider network by evaluating potential network providers, negotiating contracts, and establishing relationships with healthcare providers to ensure a comprehensive and high-quality network
Contributing to optimizing the network's performance and effectiveness by analyzing network data, utilization patterns, and market trends to identify opportunities for network enhancements, cost savings, and improved access to care
Managing the performance of network providers, including tracking key performance indicators, analyzing provider performance data, and implementing performance improvement initiatives
Conducting market analysis, assessing competitive landscapes, and making recommendations for network expansion strategies
Communicating findings to executive leadership and stakeholders, identifying opportunities for improvement and cost containment
Managing operational aspects of the team, subsequently implementing workforce and succession plans to meet business goals and objectives
Guiding management for individual performance evaluations aimed to provide critical feedback for skills development and depth of work area experience
Qualification
Required
10+ years of experience in managed care; leading and managing teams
Experience contracting with providers and hospital systems within the territory
Comprehensive understanding of hospital and physician financial issues and how to leverage technology to achieve quality and cost improvements for both payers and providers
In-depth knowledge of various reimbursement structures and payment methodologies for both hospitals and physicians
Comprehensive understanding of value-based strategies and population health management, and Aetna's related strategic initiatives
Strong experience building and maintaining relationships with large hospitals/provider systems, integrated delivery systems and large physician groups
Understands the regulatory environment and ensures contractual compliance with federal and state requirements
Expertise in market level management, cost drivers and levers, and knowledge of economic, regulatory and marketplace issues
Possess exceptional leadership skills and transformational experience with a proven track record of delivering results
High ability to drive new strategies or initiatives in highly cross-functional environments
Expertise with influencing and navigating a highly matrixed environment
Effectively lead and motivate teams to ensure high standards of performance and outcomes
Strong analytical and critical thinking skills. Focus on driving disciplined, fact-based decisions, and executing with discipline and urgency
Success in moving from current traditional strategies to new, modified approaches championing change
Person must reside within the market (PA or WV) or neighboring states with a willingness to travel within the market states
Bachelor's degree is required
Benefits
Affordable medical plan options
401(k) plan (including matching company contributions)
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
Company
CVS Health
CVS Health is a health solutions company that provides an integrated healthcare services to its members.
10001+ employees
Funding
Current Stage
Public CompanyTotal Funding
$4BKey Investors
Michigan Economic Development CorporationStarboard Value
2025-08-15Post Ipo Debt· $4B
2025-07-17Grant· $1.5M
2019-11-25Post Ipo Equity
Leadership Team
David Joyner
President and Chief Executive Officer, CVS Health
Chandra McMahon
SVP & CISO
Recent News
2026-01-25
Company data provided by crunchbase