Lead Director, Network and Trend Optimization, CVS Health

CVS Health

Location:
United States, Remote

Category:
Finance

Contract Type:
Employment contract

Salary:

100000.00 - 231540.00 USD / Year

Save Job

Apply Position

Job Description:

The Lead Director, Regional Network and Trend Optimization serves as a pivotal liaison between Network, Finance, Clinical Operations, and Sales Teams. This role is responsible for identifying and implementing opportunities to enhance cost efficiency and quality performance within the region. The incumbent will collaborate closely with the Network's data and analytics teams to analyze healthcare cost trends and leverage resources effectively to maximize results.

Job Responsibility:

Act as the primary point of contact for the West Region between network, medical economics, clinical operations, finance team, and sales teams to align financial strategies with clinical objectives and market needs
Develop and execute strategic initiatives through pricing, network curation, and medical management that lead to sustainable long-term growth and revenue
Develop and implement strategies to align with network contracting priorities with commercial trend management goals
Ensure the organization maintains competitive network arrangements to support cost-effective and high-quality care delivery
Serves as the primary point of contact between Network Contracting and Commercial Teams for the Region
Collaborate with network teams, and sales to improve cost positions in core markets
Leverage high-value networks and innovative payment models to enhance care affordability and access
Identify and execute meaningful initiatives to mitigate trends and provide competitive products
Track and analyze industry trends and healthcare utilization benchmarks
Provide actionable insights to contracting teams to ensure strategic decision-making
Maintain rigorous discipline in reviewing and anticipating trends
Collaborate with Local Market Trend Committees and National Commercial Trend Committees
Partner with sales teams in top-tier priority markets to develop strategies that improve our network's cost position and support commercial objectives
Participate in high-level meetings with network leadership and commercial stakeholders to present findings, propose initiatives, and drive decision-making processes
Act as a subject matter expert in network performance and trends for the Region
Establish and oversee key performance indicators (KPIs) to track the success of implemented strategies and ensure continuous improvement
Develop and deliver regular updates to leadership on network performance and trend analysis
Create dashboards and reports that track progress toward achieving key performance indicators
Supporting commercial stakeholders and priority market needs to align network cost strategies with growth objectives

Requirements:

Minimum of 7-10 years in healthcare industry experience, network management, contracting, actuarial, underwriting, finance, clinical operations, trend analytics, and/or related field
At least 5 years in a role involving cross-functional collaboration
Strong understanding of healthcare systems, reimbursement models, healthcare cost trends, network contracting principles, and provider relations
Proven ability to analyze and interpret complex data sets to develop actionable strategies
Strong communication skills, including experience presenting to senior leadership
Strong analytical abilities with proficiency in data interpretation and financial modeling
Proven track record of implementing cost-saving initiatives without compromising quality of care
Ability to influence and drive change within a complex organizational structure
Bachelor's degree preferred in healthcare administration, Finance, Business or a related field/specialized training/relevant professional qualification

Nice to have:

Experience working with sales teams and commercial stakeholders
Experience with healthcare data analytics platforms and electronic health record (EHR) systems
Knowledge of regional healthcare regulations and reimbursement models
Certification in healthcare finance or management (e.g., HFMA, ACHE)

What we offer:

Affordable medical plan options
401(k) plan with matching company contributions
Employee stock purchase plan
No-cost wellness screenings
Tobacco cessation programs
Weight management programs
Confidential counseling
Financial coaching
Paid time off
Flexible work schedules
Family leave
Dependent care resources
Colleague assistance programs
Tuition assistance
Retiree medical access

Additional Information:

Job Posted:
October 15, 2025

Expiration:
November 06, 2025

Employment Type:

Fulltime

Work Type:

Remote work

View All Jobs In This Company

Job Link Share:

Lead Director, Network and Trend Optimization