Executive Director, Individual Exchange Strategy and ...

Job DescriptionFully accountable leader, charged with managing sustainable Individual Exchange P&L, market performance, delivering growth and managing costs in alignment with strategy and operating plan goals.Responsible for achieving target market position, overall financial performance of Individual Exchange plans within the Market, and local execution of Risk Adjustment, compliance, and revenue yield in collaboration with corporate teams.Drives local product strategy, local market intelligence, and cost structure reduction (SAIs) in collaboration with Individual COE leadership, the market president(s) and related teams.Responsible for managing cost structure, HEDIS, and Revenue Integrity fluences Individual sales, operations, contracts, provider relations, network development, utilization management, quality improvement and coordinates and monitors functional integration of these areas in cooperation with corporate departments to achieve planned business results.Directs all departments and teams in the development, implementation and maintenance of policies and procedures to ensure compliance with State and Federal regulatory requirements.Responsible for the plan performance related to all required Federal audits.Monitors budget in assigned function areas and takes corrective action.Coaches, mentors, and manages performance of team members; drives talent development and actively builds bench.Creates a customer focused culture and collaborates across the organization to ensure internal and external constituent needs are met.Pay RangeThe typical pay range for this role is:Minimum: 131,500Maximum: 289,300Please keep in mind that this range represents the pay range for all positions in the job grade within which this position falls. The actual salary offer will take into account a wide range of factors, including location.Required QualificationsKnowledge of insurance regulatory and contractual requirements.3-5 years of solid Individual Exchange experience.7-10 years of experience in Business Development,direct sales or Client Management Leadership.Ability to develop and execute strategy.P&L expertise and strong financial, bottom-line focus.Strong affinity understanding of target audiences,needs and sales management.Strong facilitative leadership and business problemsolving skills.Ability to effectively interact with a diverse workforce and cross functional groups.Ability to deal effectively with multiple internal andexternal clients.Knowledge of value-based agreements.COVID RequirementsCOVID-19 Vaccination RequirementCVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated. You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.Preferred QualificationsDeep knowledge of local markets in the States ofCalifornia.Experience working in a matrixed environment.Previous experience working for a large, national carrier.EducationBachelor's Degree or equivalent work experience.Business OverviewBring your heart to CVS HealthEvery 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. We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.

Created: 2025-09-06