Director, Payer Programs - Pharmacy Clinical Services

Director, Payer Programs - Pharmacy Clinical Services

As Director, Payer Programs (Rx Clinical Services), you will lead pharmacy clinical services contracting and payer relationship development to secure partnerships with government and commercial payers nationwide. In this role, you will blend strategy, business development, negotiation, critical thinking, and relationship management to advance pharmacist scope of practice initiatives, ensure compliance with regulatory requirements, and drive sustainable value for Walmart Health & Wellness. By establishing strong payer partnerships, you will expand access to affordable pharmacist-led care in underserved communities and help transform how patients experience healthcare.

What You'll Do

• Direct pharmacy clinical services contracting by overseeing complex negotiations, governance structures, and regulatory projects, ensuring favorable agreements and compliance with evolving state and federal requirements.
• Lead reporting and performance management processes, including KPI development, market forecasting, and presenting insights and strategy recommendations to governance committees and executive leadership.
• Identify payer partnership opportunities, guide business development efforts, and leverage financial modeling and business cases to expand pharmacist-led services and support sustainable growth.
• Establish and maintain strong internal and external partnerships, collaborating with key stakeholders to improve efficiency, ensure effective program implementation, and advance Walmart's payer contracting strategy.
• Build and mentor a strong team by fostering talent development, encouraging accountability, and driving excellence in payer contracting and partnership management.

About the team: The Rx Clinical Services – Payer Programs team leads Walmart's efforts to expand coverage of pharmacist-led care by establishing and managing payer partnerships nationwide. We focus on governance, compliance, and effective implementation to ensure sustainable payer programs. In this role, you will play a critical part in advancing Walmart's mission to increase access to affordable, community-based healthcare at scale.

What you'll bring:

• Experience leading complex payer contract negotiations, including medical benefit, physician, and value-based care agreements across Medicaid, Medicare, Commercial, and Exchange lines of business.
• Proven ability to build and oversee payer governance structures, ensuring compliance with evolving state and federal regulations.
• Strong financial and analytical acumen, with expertise in forecasting, KPI reporting, and developing business cases to support sustainable payer programs.
• Demonstrated success leading teams and influencing stakeholders, with a track record of developing talent and driving large-scale initiatives.
• Passion for advancing pharmacist scope of practice and improving healthcare access for underserved populations nationwide.

Minimum Qualifications

Bachelor's degree business, finance, accounting, economics, or related area with 7 years' experience in managed care contracting/negotiations, healthcare billing, healthcare finance, or healthcare compliance/legal; or Ten years of relevant experience in managed care contracting/negotiations, healthcare billing, healthcare finance, or healthcare compliance/legal. Demonstrated experience in payer negotiations or relationship management; must be able to speak to concrete experiences and positive outcomes. Well-developed understanding of healthcare financing, revenue cycle processes and care delivery. Previous supervisory experience. Proficiency with all Microsoft tools.

Preferred Qualifications

Experience with at least five of those years in a director or above role with a commercial or government program Payer or Provider Organization., Master's degree in Business, Healthcare, Finance, or related area, Supervisory experience

Primary Location

2501 Se J Street Ste B, Bentonville, AR 72712-7761, United States of America