Chris Town, chief executive of the former Greater Peterborough PCT, received a redundancy package worth£480,000 in December 2006 following a structural shake-up carried out as part of Commissioning a Patient-led NHS.
Three months before being made redundant, Mr Town, who earned around£120,000 a year, was seconded to the newly formed Cambridgeshire PCT as interim chief executive.
After failing to secure either the full-time post at Cambridgeshire or the top job at the renamed Peterborough PCT, he was made redundant and paid off by the trust.
The redundancy package was underwritten by NHS East of England. The strategic health authority ended the last financial year£152m in debt.
Last month, it warned there might be staffing cuts over the coming year.
The payout, revealed following a request under the Freedom of Information Act, has infuriated senior managers and politicians, particularly in light of the region's financial problems.
Stewart Jackson, Conservative MP for Peterborough and a member of the Commons health select committee, said: 'It's scandalous that funds are being spent in that way. It's a shockingly high amount of money.
'To throw public money around like this with no accountability is just wrong. It shows the true cost of reconfiguration to the taxpayer.'
Mr Town is now chairing two workstreams at the Working in Partnership Programme, an NHS arm's-length body that aims to support general practice.
Mr Town is paid around£600 a day, but works only one or two days a month. He also works part-time as a consultant in the private sector.
A senior NHS manager who did not want to be named said: 'We all ask why he was given this amount. It's quite galling.
'There's a lot of resentment at the amount of money given out, especially considering he's pitched up again in the NHS.'
Mr Town told HSJ: 'I worked in the NHS for over 30 years and, when you've done service like that, it seems not unreasonable. I was over 50, so some of the money went into my pension.
'If you look at what some of the SHA chief executives get when they're made redundant, it doesn't seem like so much money.'
He added: 'I went for the jobs at Cambridgeshire and Peterborough but didn't get them - they were new PCTs and they wanted to make sure they had the right person for the job.'
NHS East of England defended the pay-off, saying it was in line with the NHS redundancy scheme in place during the restructuring programme.