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
As the Lead Director, DSNP Program Management you will plan, monitor and manage internal projects from initiation through completion. You will secure required resources and uses formal processes and tools to manage resources, budgets, risks and changes.
Fundament Job Components:
- Direct team throughout the development, implementation, and execution of the Dual Eligible Special Needs Plan (DSNP)program that provides specialized care for individuals who are eligible for both Medicare and Medicaid (dual eligible beneficiaries).
- Manage projects to ensure on-time completion according to specifications and within budgeted costs
- Apply advanced knowledge of the Medicare and Medicaid regulatory landscape to ensure program compliance with federal and state regulations governing DSNP programs.
- Conduct advanced research on innovative healthcare delivery models that may enhance the impact of the DSNP program.
- Consult on critical quality metrics for the DSNP program with stakeholders and implements evidence-based interventions to optimize program outcomes and improve member experiences.
- Develop methods for monitoring program expenditures and financial resources while maintaining program quality and compliance.
- Collaborates with healthcare providers, care managers, social workers, and other stakeholders to ensure integrated and coordinated care for dual eligible beneficiaries.
- Evaluate the feasibility of integrated care models, care coordination strategies, and telehealth solutions for DSNP members.
- Develop strategies for identifying and enrolling eligible individuals into the DSNP program and provides support to beneficiaries throughout the enrollment process.
- Coordinate the development and dissemination of educational materials and resources to beneficiaries to help them understand their benefits and access appropriate care.
Required Qualifications
- 5 plus years of experience with serving as health plan lead and liaison to the State Departments of Health (ideally in NY)
- Experienced and knowledgeable regarding Medicaid, Medicare and Duals regulations and programs
- Previous experience working cross-functionally within a highly matrixed health plan
- Experience in managing an operational function within a health plan
- 3 plus years developing effective strategies in designing an effective Duals program in an ever-changing regulatory environment
- Highly collaborative and experience presenting and communicating externally
- Excellent verbal and written communication skills
- Previous experience leading duals strategies and execution preferably for NY and for Maine.
Education
- Bachelor's degree or equivalent 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 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: 06/02/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
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What We Do
CVS Health is the leading health solutions company that delivers care in ways no one else can. We reach people in more ways and improve the health of communities across America through our local presence, digital channels and our nearly 300,000 dedicated colleagues – including more than 40,000 physicians, pharmacists, nurses and nurse practitioners.
Wherever and whenever people need us, we help them with their health – whether that’s managing chronic diseases, staying compliant with their medications, or accessing affordable health and wellness services in the most convenient ways. We help people navigate the health care system – and their personal health care – by improving access, lowering costs and being a trusted partner for every meaningful moment of health. And we do it all with heart, each and every day.
