Payer Relations Director - Remote
CVS Health
Woonsocket Rhode Island
United States
Customer Service / Call Center
(No Timezone Provided)
Job Description
The Payer Relations Director has the oversight and management of an assigned book of business including Pharmacy Benefit Managers, Blue Cross Plans, National Insurance Carriers, Regional Health Plans and State Medicaid Plans. You will develop and maintain payer relationships including contract negotiations, contract management and profitability targets specifically related to pharmacy spend and market share. The additional role and responsibilities of the Regional Director will include strategic account relations, supporting limited to limited/preferred networks, Preferred Part D networks, clinical initiatives, and Specialty Connect. The Regional Director will work with executive officers across the company, including daily / weekly contact with the Director of Payer Relations, Vice President of Payer Relations, Managers, Directors and Vice Presidents in Legal, Retail Operations, Marketing, Real Estate, Specialty and Merchandising.
You will report to the Senior Director of Payer Relations.
You will have the following skills:
• Structured & Logical Thinking: The ability to identify and determine our problems and develop strategic, analytical, and financial frameworks to conduct analysis and measure success.
• Analytical Rigor: capability conducting quantitative portfolio growth analysis.
Required Qualifications
• Minimum of 5 years of professional work experience within Pharmacy Benefit Management or Retail Pharmacy Industry.
• Minimum of 5 years of experience drafting and negotiating contracts and associated financial frameworks.
COVID Requirements
COVID-19 Vaccination Requirement
CVS Health requires its Colleagues in certain positions to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, pregnancy, or religious belief that prevents them from being vaccinated.
- If you are vaccinated, you are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status within the first 10 days of your employment. For the two COVID-19 shot regimen, you will be required to provide proof of your second COVID-19 shot within the first 45 days of your employment. Failure to provide timely proof of your COVID-19 vaccination status will result in the termination of your employment with CVS Health.
- If you are unable to be fully vaccinated due to disability, medical condition, pregnancy, or religious belief, you will be required to apply for a reasonable accommodation within the first 10 days of your employment in order to remain employed with CVS Health. As a part of this process, you will be required to provide information or documentation about the reason you cannot be vaccinated. If your request for an accommodation is not approved, then your employment may be terminated.
Preferred Qualifications
• Passion for Health Care: A history of work in the health care industry and an ongoing desire to make one of the world's strongest health care companies even stronger.
• Powerful Communication: The ability to communicate effectively and succinctly with a diverse range of constituents, both verbally and on paper, and with all levels of an organization. Communicate in an open and honest way that quickly builds trust and respect.
• Team Leadership: Developed relationship-building skills to foster effective working relations across the Retail Enterprise.
• Influencing others: Must possess the ability to structure useful guidance around complex and far reaching strategy decisions to influence and guide the decisions made by others
Education
Bachelors' Degree or equivalent years of related professional work experience in combination with years education in lieu of a degree.
Business Overview
At CVS Health, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.
We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, sex/gender, sexual orientation, gender identity or expression, age, disability or protected veteran status or on any other basis or characteristic prohibited by applicable federal, state, or local law. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.
Payer Relations Director - Remote
CVS Health
Woonsocket Rhode Island
United States
Customer Service / Call Center
(No Timezone Provided)
Job Description
The Payer Relations Director has the oversight and management of an assigned book of business including Pharmacy Benefit Managers, Blue Cross Plans, National Insurance Carriers, Regional Health Plans and State Medicaid Plans. You will develop and maintain payer relationships including contract negotiations, contract management and profitability targets specifically related to pharmacy spend and market share. The additional role and responsibilities of the Regional Director will include strategic account relations, supporting limited to limited/preferred networks, Preferred Part D networks, clinical initiatives, and Specialty Connect. The Regional Director will work with executive officers across the company, including daily / weekly contact with the Director of Payer Relations, Vice President of Payer Relations, Managers, Directors and Vice Presidents in Legal, Retail Operations, Marketing, Real Estate, Specialty and Merchandising.
You will report to the Senior Director of Payer Relations.
You will have the following skills:
• Structured & Logical Thinking: The ability to identify and determine our problems and develop strategic, analytical, and financial frameworks to conduct analysis and measure success.
• Analytical Rigor: capability conducting quantitative portfolio growth analysis.
Required Qualifications
• Minimum of 5 years of professional work experience within Pharmacy Benefit Management or Retail Pharmacy Industry.
• Minimum of 5 years of experience drafting and negotiating contracts and associated financial frameworks.
COVID Requirements
COVID-19 Vaccination Requirement
CVS Health requires its Colleagues in certain positions to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, pregnancy, or religious belief that prevents them from being vaccinated.
- If you are vaccinated, you are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status within the first 10 days of your employment. For the two COVID-19 shot regimen, you will be required to provide proof of your second COVID-19 shot within the first 45 days of your employment. Failure to provide timely proof of your COVID-19 vaccination status will result in the termination of your employment with CVS Health.
- If you are unable to be fully vaccinated due to disability, medical condition, pregnancy, or religious belief, you will be required to apply for a reasonable accommodation within the first 10 days of your employment in order to remain employed with CVS Health. As a part of this process, you will be required to provide information or documentation about the reason you cannot be vaccinated. If your request for an accommodation is not approved, then your employment may be terminated.
Preferred Qualifications
• Passion for Health Care: A history of work in the health care industry and an ongoing desire to make one of the world's strongest health care companies even stronger.
• Powerful Communication: The ability to communicate effectively and succinctly with a diverse range of constituents, both verbally and on paper, and with all levels of an organization. Communicate in an open and honest way that quickly builds trust and respect.
• Team Leadership: Developed relationship-building skills to foster effective working relations across the Retail Enterprise.
• Influencing others: Must possess the ability to structure useful guidance around complex and far reaching strategy decisions to influence and guide the decisions made by others
Education
Bachelors' Degree or equivalent years of related professional work experience in combination with years education in lieu of a degree.
Business Overview
At CVS Health, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.
We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, sex/gender, sexual orientation, gender identity or expression, age, disability or protected veteran status or on any other basis or characteristic prohibited by applicable federal, state, or local law. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.