Description

At CVS Health, 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 reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.

Position Summary

The Lead Director, Provider Portal Strategy & Operations is responsible for the strategic leadership and operational oversight of Aetna's three primary provider portal solutions: Availity Commercial/Medicare Portal, Availity Medicaid Portal, and DentalXchange Dental Portal. This role partners with our DDAT teams to develop the portal strategy and roadmap. Encompasses ownership for performance, vendor relationships, compliance, and team leadership, ensuring the delivery of exceptional provider experiences and operational excellence.

Key Responsibilities

Strategic Leadership:

o Develop and execute comprehensive portal strategies and roadmaps aligned with prioritized provider experience initiatives and workflow requirements.

o Collaborate with senior management to define strategic objectives and investment priorities for portal enhancements.

Operational Excellence:

• Oversee portal performance, including file/data processing, system uptime, outage management, defect resolution, and incident response coordination.
• Lead cross-functional teams to deliver projects and programs from initiation through completion, ensuring timely delivery within budget and scope.

Vendor & Contract Management:

• Manage portal vendor relationships, including contract renewals, administration, invoicing (over $16M), payment processes, and regular business reviews in partnership with procurement and finance.
• Coordinate monthly and quarterly health checks and business reviews with vendors.

Compliance & Risk Management:

• Ensure ongoing compliance through annual security risk assessments, user entitlement validation, recertification, business continuity planning, and process documentation.
• Coordinate responses to compliance incidents, including potential PHI breaches and audits.

Project & Program Management:

• Identify project stakeholders, establish effective communication channels, and manage expectations.
• Monitor expenditures and ensure adherence to financial constraints throughout the project lifecycle.
• Prepare and present progress reports to stakeholders and senior management.
• Develop and implement mitigation strategies to minimize risks and ensure project success.
• Identify opportunities for process improvement and implement best practices, lessons learned, and industry standards.

Team Leadership:

• Provide leadership and guidance to project and program teams, assigning responsibilities, setting performance expectations, and motivating team members to achieve objectives.

Required Qualifications

• 10+ years of healthcare experience, preferably working with network and provider related operations and strategy.
• 5+ years leading and developing high functioning teams
• Adept at execution and delivery (planning, delivering, and supporting) skills
• Adept at business intelligence
• Adept at collaboration and teamwork
• Mastery of problem solving and decision making skills
• Mastery of growth mindset (agility and developing yourself and others) skills

Preferred Qualifications

• Experience with digital portal and/or self-service capabilities

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 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.

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 all 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, visit https://jobs.cvshealth.com/us/en/benefits

We anticipate the application window for this opening will close on: 12/31/2025

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