Executive Director, Chief Duals Officer – Southeast Region

Job Description
The National Duals Segment supports duals growth,
expansion, strategy, clinical and administrative operations,
and overall performance of all dual products. This position
is focused on supporting overall market performance and
growth by collaborating with key enterprise, market, and
segment leadership to support dual products within a
specified geographical region (Southeast Region includes
AL, AR, FL, GA, LA, MS, NC, SC and TN). This position
will be responsible for working with enterprise, market,
segment departments and functions that support Aetna’s
dual products, this position will serve as liaison focused on
monitoring effectiveness and impact of state strategy,
sales, product competitiveness, network, and overall
product P & L performance within the specified territory.
This position will have significant interaction with market
DSNP Program Managers, assisting and coaching to
ensure success.

To be successful in this position, the candidate must have
demonstrated experience in developing dual (specifically
DSNP) growth strategies, in managing performance
including marketing and sales, state strategy, product
development, regulatory requirements, and financial
performance. The successful candidate will have a
demonstrated ability to work in a highly matrixed
organization and proven success in such an environment.
Monitor and contribute to duals product performance
including Marketing and Sales, Network, Product, Market
Performance and Regulatory Compliance. Lead strategic
efforts to increase growth and financial performance of
duals products in multiple states by working with state and
product leadership.

Other key responsibilities include:
– Drive growth and member experience as well as
overseeing P&L performance for dual products
– Serve as liaison + SME supporting duals growth and
expansion
– Collaborate with segment and product team leadership
on DSNP benefit and bid strategy
-Strong collaboration with Chief Medicare Officers and Aetna Medicaid leadership in assigned markets to drive
shared opportunities
– Partner with DSNP Program Managers to drive success,
nurture state relationships/local partnerships and assure
SMAC compliance
– Contribute to segment strategic planning and
development of annual operating plan for Dual markets
– Identify financial opportunities for revenue enhancement,
membership growth, medical cost savings, quality
improvement, and administrative cost efficiencies
– Partner with markets to drive duals local product strategy
and local market intelligence, partnering to achieve target
market position
– Achieve market performance goals via local execution of
STARs/quality withhold, compliance, and cost structure
reduction (SAIs) initiatives in collaboration with Medicare
market leadership, Dual’s segment leadership and related
operational teams
– Work with marketing and sales, network, member
retention, operations, and related operational areas to
identify improvement opportunities focused on improving
financial outcomes and member and provider engagement
and satisfaction
– As applicable, serve as lead and SME collaborating with
enterprise teams on expansions or new products in the
assigned territory including integrated products such as
FIDE SNPs, MMPs, and HIDE SNPs. Develop a
comprehensive implementation plan for such products in
collaboration with markets
– Develop and participate in presentations and
consultations to internal and external audiences
– Monitor performance and outcomes of new and
established programs and services

Required Qualifications
– 10+ years leadership experience
– Must have Medicare and DSNP experience including
state strategy, marketing and sales, product development,
and member retention
– Must have P&L knowledge and possess a strong financial bottom-line focus
– Strong facilitative leadership and business problem
solving skills
– Effective technical skills regarding health plan
administration, profit and loss accountability, medical
management, business development, member
engagement, quality outcomes, contract compliance,
provider satisfaction, value-based contracting, local
marketing/community outreach.
– Resides in and has knowledge of current DSNP marketplace dynamics in Southeast Region (AL, AR, FL,
GA, LA, MS, NC, SC, TN).
– Ability to build relationships with a diverse workforce and
cross functional groups.
– Proven ability to work successfully within a matrix
environment and influence internal stakeholders.
– Align with the Heart at Work Behaviors of CVS Health
– Put people first; Join forces; Inspire Trust; Rise to the
Challenge; Create Simplicity

COVID Requirements

COVID-19 Vaccination Requirement
CVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated.

You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.

Preferred Qualifications
Experience with Medicaid managed care including
managed long-term care services and supports preferred

Education
Bachelors in a related field

Business Overview
Bring your heart to CVS Health
Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand – with heart at its center – our purpose sends a personal message that how we deliver our services is just as important as what we deliver.

Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.
We strive to promote and sustain a culture of diversity, inclusion and belonging every day.
CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.