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.
The Lead Director, Provider Data Services provides enterprise leadership across multiple Provider Data Services units and is accountable for the end‑to‑end delivery of provider data operations, including production, quality assurance, audit, reporting, and continuous process improvement. This role oversees the maintenance of provider data across Behavioral Health, National, Dental, Indirect, and First Health networks, ensuring accurate, timely, and compliant provider records that support proper reimbursement and member access, including directory accuracy.
The Lead Director aligns Provider Data Services policies, procedures, and operating standards with enterprise goals and regulatory requirements, while delivering financial, operational, and service outcomes. This role provides leadership through multiple layers of management and vendor partners, setting strategic direction, establishing priorities, and driving operational excellence at scale.
Key Responsibilities
Operational & Strategic Leadership
- Accountable for the operational performance of Commercial and Medicare provider data services functions.
- Lead and direct a highly complex operation of 100+ colleagues through multiple managers.
- Provide oversight of offshore vendor partnerships, ensuring capacity planning, inventory management, and service level alignment with business objectives.
- Define and execute provider data process improvement strategies to address performance trends, risk, and scalability.
- Drive change management initiatives that enable modernization, efficiency, and adaptability within a dynamic healthcare environment.
Governance, Quality & Compliance
- Ensure consistent execution of Provider Data Services policies and procedures across the enterprise.
- Oversee audit programs and quality controls to maintain accurate provider records supporting reimbursement integrity, contractual compliance, and directory accuracy.
- Partner with internal stakeholders to mitigate risk, address audit findings, and maintain regulatory readiness.
People & Partner Leadership
- Build, develop, and sustain a strong leadership bench through formal training, coaching, mentoring, performance management, and succession planning.
- Cultivate and manage strategic relationships with internal business partners across Network, Credentialing, Operations, Compliance, and Technology.
- Influence and align cross‑functional teams to advance Provider Data Services priorities and enterprise initiatives.
Financial & Resource Management
- Control departmental resources to achieve financial targets and operational objectives within established budget parameters.
- Contribute to enterprise planning and execution of initiatives that advance Provider Data Services strategy and value delivery.
Required Qualifications
- 10+ years of experience in managed care, network operations, provider data, or health insurance, including large‑scale production environments.
- Demonstrated experience leading complex operations through multiple layers of management.
- Proven ability to drive execution, operational rigor, and measurable outcomes in a matrixed organization.
- Advanced working knowledge of systems, applications, and tools supporting provider data and inventory management.
- Strong record of cross‑functional collaboration and influencing at senior leadership levels.
- Ability to lead change, apply analytical thinking, and make data‑driven decisions.
- Demonstrated sound judgment in complex, regulated operational environments.
Preferred Qualifications
- Experience managing offshore or external vendor partnerships.
- Project or program management experience within large, regulated organizations.
Education
- Bachelor’s degree or equivalent relevant work experience.
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 offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.
This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.
Additional details about available benefits are provided during the application process and on Benefits Moments.
We anticipate the application window for this opening will close on: 05/29/2026
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
