Payer Relations Account Executive

Posted:
11/5/2024, 4:00:00 PM

Location(s):
Rhode Island, United States

Experience Level(s):
Expert or higher ⋅ Senior

Field(s):
Customer Success & Support ⋅ Sales & Account Management

Workplace Type:
Remote

Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as what we deliver.
 
Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.

Position Summary

As a Payer Relations Account Executive, you support a Payer Relations Director (PRD) in managing one of the largest and most complex PBM relationships that spans multiple lines of business and has direct ties to a significant health plan. In this role, you will help develop the payer specific strategy, value proposition, goals, and targets. You will be involved in aspects of the PBM relationship including, but not limited to, negotiating network contract/term, script growth opportunities, margin retention, clinical program partnerships, specialty network contracting, and other claims-processing operational efficiencies. This individual may also have responsibility and be the primary liaison for a book of smaller PBMs with oversight from a PRD.

This position’s primary objective is to support the PRD in developing and maintaining profitable payer relationships and is an excellent opportunity to interface with Executive Leadership both internally and externally. You are considered one of the main points of contact for the PBM, acting as the liaison between PBMs and cross-functional internal teams and responsible for ensuring timely/successful delivery of PBM requests. Excellent communication skills are required to ensure CVS Pharmacy understands a PBM’s needs and is able to build long-lasting, mutually beneficial relationships with our key business stakeholders.

The successful candidate will possess the following skills:

  • Demonstrated ability to effectively lead internal and client calls.
  • Excellent verbal and written communication skills
  • Ability to pull data utilizing web-based reporting platforms in order to track and identify scripts and margin trends.
  • Consistent delivery of client interactions that develop trust and show value to position CVS Pharmacy for long term growth with PBMs
  • A high level of customer service through accurate, responsive, reliable, and professional interactions
  • A growth mindset open to developing financial acumen and analytical rigor around pharmacy economics


The Payer Relations Account Executive responsibilities will include managing the resolution status of routine to complex requests related to our PBM relationships; including but not limited to:

  • Complex issue tracking - Engaging internal departments and PBM resources to work on outstanding issues from start to resolution.
  • Driving Practical & Creative Solutions – Critically thinking about complex situations to find optimal outcome.
  • Engaging Appropriate Resources – Discuss information at varying degrees of complexity, at varying stages of progression, and engage internal or PBM resources best appropriate to drive issue resolution.
  • Working within Deadlines - Drive resolution within a timely manner

This position can be located anywhere in the U.S. with the ability to work remotely or in a CVS Corporate Hub. This role will require travel to different locations throughout the country. The amount of travel will vary depending on our client’s need but could be up to 20% of the time.

Required Qualifications

  • At least 5 years of cumulative Pharmacy, PBM, Account Management, or similar healthcare experience in a client-facing role
  • Travel may be required but is not limited to flights, overnight stays, local travel, travel on short notice and other travel deemed necessary by the Company

Preferred Qualifications

  • 5+ years of experience of payer relations experience managing a book of business in a Pharmacy, PBM, Health Plan, or medical specialty and infusion industry

Education

Bachelors degree, or equivalent experience

Pay Range

The typical pay range for this role is:

$82,940.00 - $182,549.40


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. 
 
In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities.  The Company offers a full range of medical, dental, and vision benefits.  Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees.  The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners.  As for time off, Company employees enjoy Paid Time Off (“PTO”) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies. 
 
For more detailed information on available benefits, please visit Benefits | CVS Health

We anticipate the application window for this opening will close on: 11/20/2024

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