Lead Director, ISNP and SNFist Program

Job Description
Develop, and expand the services available for institutionalized special needs members from your leadership role in Aetna’s rapidly growing Duals Segment. Support Duals growth strategy, operational alignment and manage partner internal and external relationships for institutionalized and institutionally eligible members including ISNPs and MMPs. This position is responsible for the development and expansion of the ISNP program. This leader will work cross-functionally across the enterprise and segment teams as a liaison focused on promoting the effectiveness and impact of ISNP and SNFist programs and will facilitate development and implementation of programs, enhancements, and new initiatives.

This resource will work collaboratively from a leadership perspective to develop and refine the ISNP and SNFist programs. Responsibilities will include relationship management, strategy development and execution, regulatory process oversight including quality and model of care related processes, and operational alignment / issue resolution.

To be successful in this position, the candidate must have demonstrated experience with the ISNP model of care, and ISNP plans/programs. This leader will actively collaborate across Aetna’s member, network services and other core operational teams to facilitate ISNP and SNFist-type programs.
• Serve as the ISNP champion and organizational SME for products and programs designed for institutionalized or institutionally eligible Medicare members.
• Lead development of programs designed to support institutionalized populations within special needs plans and MMPs. Develop, refine, and execute the growth strategy in partnership with segment and cross-functional teams
• Collaborate with executive leadership throughout the organization to develop and implement program strategies that meet business needs, federal/state regulations and accrediting agency requirements for members residing in or eligible for institutionalized care
• Serve as relationship manager with key internal and external partners to develop and enhance the ISNP program
• Work with cross functionally within Medicare and Duals Segment operations and reporting to identify improvement opportunities
• Oversee MOC and quality committee reporting for ISNP
• Serve as clinical, technical, professional, and business resource and DSNP subject matter expert
• Develop and participate in presentations and consultations to internal and external audiences
• Monitor performance and outcomes of new and established programs and services
• Maintain national stakeholder relationships critical to thought leadership innovation and policy

Pay Range
The typical pay range for this role is:
Minimum: 100,000
Maximum: 227,000

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.

In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company's 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off (PTO) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.

For more detailed information on available benefits, please visit

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Required Qualifications
• 8+ years of experience in Medicaid and or Medicare program operations
• 5+ years management and/or organizational leadership
• 3+ years ISNP and/or IE SNP managed care experience
• Experience working with dual eligible and complex populations
• Experience managing vendor partnerships
• Multiple years proven leadership experience setting strategic direction and influencing change that resulted in quantifiable positive outcomes
• Demonstrated relationship management skills at the senior level; capacity to quickly build and maintain credible relationships at varying levels of the organization simultaneously.
• Experience with enterprise-wide and/or cross-functional large scale initiatives with high degree of complexity
• Demonstrated ability to successfully implement change amongst cross-functional teams
• Demonstrated ability to synthesize and communicate program performance and outcomes
• Demonstrated superior business process, project management and organizational redesign experience

Preferred Qualifications
Previous experience managing ISNP and / or SNFist programs

Education
BA

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. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.