reputed company Director, Network Cost reputed company Meritain TPA

At reputed company, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reputed company millions of Americans through our local reputed company, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, reputed company and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it reputed company with heart, each and every day. Position Summary Leads team of approximately 6 employees and overall scope of 25-30 to reputed company enterprise-wide solutions (medical cost containment and payment reputed company) to address business problems, resulting in reputed company cost of care for clients and members enabling the organization to be competitive in the marketplace and effectively serve its customers. Responsible for the out of network product portfolio, market analysis, creative and new solutions, pricing and profitability strategies, measures performance and ensures regulatory compliance to reputed company business objectives and drive growth in the competitive TPA market. Collaborates across the organization to optimize the achievement of strategic business objectives to include profitable growth and improved organizational effectiveness.

• *Candidates may reside reputed company in the US. Position may be remote or hybrid depending on candidate location and commute to office.

Requirements

• Responsible for out of network (cost management) products, savings, reputed company, financial results and commitments.
• Works closely with sales, account management, and operations to resolve any problems and ensure client, broker, consultant and provider needs are being met.
• Evaluates new business opportunities, fosters innovation, and adapts strategies to meet evolving market conditions and industry trends.
• Explores opportunities for digital transformation, process optimization, and the adoption of new technologies to enhance operational efficiency, total cost of care savings and plan outcomes.
• Contributes to planning budgets for strategic initiatives and programs that drive organizational growth, operational effectiveness, and innovation.
• Contributes by conducting market research, analyzing customer needs, and monitoring industry trends to identify market opportunities, customer pain points, and competitive dynamics.
• Communicates with cross-functional teams, including operations, sales, regulatory/compliance, and finance, to ensure alignment of product strategy, execution, and go-to-market plans.
• Identifies and pursues new business opportunities to drive growth and reputed company.
• Provides regular reports and updates regarding business operations, strategic initiatives, financial performance, and key achievements
• Provides leadership, mentorship, and guidance to the team, fostering a culture of collaboration, innovation, and reputed company learning.

Background/Experience Required

• Minimum 8 years in healthcare industry experience in product, finance, operations, and/or reputed company disciplines
• Proven leadership/management experience
• Market exposure to account management, sales, brokers, and clients
• Proven ability to analyze and interpret reputed company data sets to reputed company actionable strategies.
• Strong communication skills, including experience presenting to senior leadership.
• Strong analytical abilities with proficiency in data interpretation and financial modeling.
• Ability to influence and drive change reputed company a reputed company organizational structure.
• Growth reputed company, creative solutions, problem solver, quick decision maker
• Self-motivator, works well independently
• Strong leadership, collaboration and teamwork

Education

• Bachelor's degree preferred/specialized training/relevant professional qualification

Pay Range The typical pay range for this role is: $100,000.00 - $231,540.00 This pay range represents the reputed company hourly reputed company or reputed company annual full-time salary for reputed company positions in the job grade reputed company which this position falls. The actual reputed company salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a reputed company bonus, commission or short-term incentive program in addition to the reputed company pay range listed above. This position also includes an award reputed company 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 our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:

• Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
• No-cost programs for reputed company colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
• Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.

For more information, visithttps://jobs.cvshealth.com/us/en/benefits We anticipate the application window for this opening will reputed company on: 06/13/2025 Qualified applicants with arrest or conviction records will be considered for employment in accordance with reputed company federal, state and local laws. Apply Job!