CVS Health · 11 hours ago
Lead Director, Network Management (Pacific Northwest)
United States
Full-time
Remote
Director/Executive
$100K/yr - $232K/yr
8+ years expCVS Health is committed to building a world of health around every individual. The Lead Director will develop strategic partnerships to ensure competitive networks and negotiate high-value contracts with complex hospital systems while managing provider engagement and cost-saving initiatives.
Health CareMedicalPharmaceuticalRetailSales
Responsibilities
Develop strategic partnerships to ensure Aetna has market leading discount and cost positions and high value, competitive networks
Design conceptual models, initiative planning, and negotiating high value contracts with complex hospital systems, integrated delivery systems and large groups
Build strong relationships with providers and execute contract strategies to yield market leading discount and cost positions
Negotiate and manage various value based payment models and manage contract performance associated with these models
Recruit providers as needed to ensure attainment of network expansion and adequacy targets
Collaborate cross-functionally to manage provider compensation and pricing development activities, submission of contractual information, and review and analysis of reports
Identify and manage cost issues and collaborate cross functionally to execute significant cost saving initiatives
Represent company with high visibility constituents, including customers and community groups
Promote collaboration with internal partners and evaluate, help formulate, and implement provider network strategic plans
Ensure resolution of escalated issues related to claims payment, contract interpretation and parameters, or accuracy of provider contract or demographic information
Help mentor and develop others within the department by providing shadowing opportunities and acting as a subject matter expert
Qualification
Required
A minimum of 8 years related experience and expert level negotiation skills with successful track record negotiating contracts with large or complex provider systems
Demonstrated knowledge of value-based contracting structures, including negotiation and implementation of agreements that align cost, quality, and performance outcomes across stakeholders
Experience with Medicare, Commercial contracting and various reimbursement methodologies
Demonstrated ability to build, manage, and grow strategic relationships that advance long-term organizational goals
Experience presenting complex information to groups in a clear, concise, and persuasive manner, adapting style and content to audience needs
Preferred
Proven working knowledge of provider financial issues and competitor strategies
Strong preference to have relationships with large health systems in Oregon, Washington and Idaho
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
H1B Sponsorship
CVS Health has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2022 (1)
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