Lead Director, Network Relations Management

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 The Lead Director will be accountable for developing strategic partnerships to ensure Aetna has market leading discount and cost positions and high value, competitive networks. Strong focus on designing conceptual models, initiative planning, and negotiating high value contracts with the most complex and challenging hospital systems, integrated delivery systems and large groups in accordance with company standards in order to maintain and enhance provider networks, while working cross functionally to ensure consistency with all contracting strategies and meeting and exceeding accessibility, quality, compliance, and financial goals and cost initiatives. Contracting responsibilities include Medicare and Commercial. Leads Provider Relations Operations & Network Strategy: Oversees teams responsible for building and managing relationships with existing and new providers across assigned geographies. Directs network development for Commercial and Medicare products, including contracting, retention, provider servicing, and ensuring compliance with policies and standards. Drives Cross‑Functional Collaboration & Operational Excellence: Partners with internal departments to implement complex provider contracts, support reimbursement methodologies, resolve billing issues, and address medical cost drivers. Serves as the primary liaison for regulatory audits, credentialing requirements, grievance and appeals monitoring, and ensures timely, compliant issue resolution. Manages Provider Education, Communication & Engagement: Develo...