We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, 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.

Position Summary

This role serves as the single financial owner of Medicare Revenue for Medicare Advantage and Medicare Part D, accountable for the end‑to‑end translation of member acuity, program policy changes, corporate revenue-focused initiatives, and risk adjustment outcomes into forecasted and booked revenue. The role aligns directly to Finance accountability for forecasts, accruals, and earnings explainability and is designed to strengthen accuracy, transparency, and decision discipline when estimating revenue outcomes.

The Executive Director of Medicare Revenue Management partners closely with Revenue Integrity (RI), Actuarial, and Product Finance but owns the financial modeling, projections, accruals, and variance explanations reflected in forecast, close, and executive reporting.

Major Responsibilities

1. Own End-to-End Revenue Modeling and Forecasting

• Own the enterprise financial modeling framework for Medicare Advantage and Part D (MA-PD) products.
• Establish and maintain a robust projection model and underlying assumptions. Project in‑year movement driven by member mix, documented conditions, corporate revenue-focused initiatives, and payment timing.
• Translate model outputs into estimated revenue impacts, sensitivity test results, and play an active role determining the final, recommended revenue accrual values.

2. Lead Accrual Development and Revenue Recognition

• Own all revenue-related assumptions and accrual modeling, including mid‑year accruals, final accruals, and any revenue‑impacting adjustments.
• Lead the development of accrual assumptions and modeling, including opportunities to enhance precision over time.
• Ensure accrual positions are defensible, consistently applied, and aligned with financial reporting standards.

3. Strengthen Accuracy and Explainability

• Lead the evolution of an analytical approach that reduces aggregation noise by identifying drivers of revenue performance and understanding the amount of variability for each driver.
• Promote consistent standards across Finance partners, including robust documentation, structured processes, and defensible analytic approaches.
• Establish and execute consistent and timely feedback loops based on actual-to-expected (AtoE) outcomes, with refinement of modeling and assumptions over time.

4. Partner with Key Internal Stakeholders

• Consume execution inputs from Revenue Integrity (activity volumes, completion rates, vendor productivity, CMS processing timing).
• Maintain clear separation between execution accountability (RI) and financial translation and booking accountability (Finance).
• Provide financial impact perspectives to inform operational prioritization and management decisions.

5. Deliver Executive‑Ready Insights and Governance

• Present CFO‑ and ELT‑ready insights on revenue performance, risks, and outlook.
• Lead reviews of forecast movement, accrual changes, and key performance drivers.
• Maintain strong governance over assumptions, analytical standards, documentation, and audit readiness.

6. Team & Leadership Expectations

• Lead and grow hybrid finance and technical team (analytics and modeling) sized to support enterprise Medicare needs.
• Act as a visible financial leader with strong judgment and executive presence.
• Operate as a proactive business partner focused on outcomes, not reporting volume.

Required Qualifications

• 10+ years of experience in healthcare finance, actuarial, or advanced analytics.
• Expertise in Medicare Advantage and Part D risk adjustment economics and CMS payment mechanics/timing.
• Demonstrated ownership of forecasts, accruals, and financial explainability.
• Experience translating complex analytics into executive‑level insights.
• Proven ability to lead high‑performing, cross‑functional teams.

Preferred Qualifications

• Actuarial credentials (ASA/FSA), advanced quantitative degrees (e.g., MS in Statistics, Data Science, or Health Economics), or other credentials demonstrating strong analytical and healthcare reimbursement expertise.
• Experience supporting Medicare bids or CMS‑related financial processes.
• Experience leading or scaling analytical capabilities within Finance.

Education

Bachelor's Degree

Pay Range

The typical pay range for this role is:

$131,500.00 - $303,195.00

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls.  The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors.  This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.  This position also includes an award target 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 offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.

This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.

Additional details about available benefits are provided during the application process and on Benefits Moments.

We anticipate the application window for this opening will close on: 07/03/2026

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.