, Illinois

Job Description
As part of the Duals Program Office team, this role will focus on the strategic alignment of LTSS initiatives into a cohesive program. Leader will identify opportunities to enhance capabilities to manage clinically and socially complex dually eligible populations. Position will be responsible for working cross-functionally across the enterprise and segment clinical teams supporting duals serving as a liaison focused on promoting the effectiveness and impact of LTSS programs as well as facilitating development and implementation of program alignment, enhancements, and new initiatives.

- Plan and monitor an end to end LTSS program that successfully supports members in the safest, least restrictive setting of choice across all required internal operational functions and external partners.
- Collaborate with executive leadership throughout the organization to develop and implement LTSS program strategies that meet business needs, federal/state regulations and accrediting agency requirements
- Serve as a liaison and leader supporting the advancement of LTSS programs and services to support duals performance and enhancing overall capabilities to manage complex populations
- Work with clinical and other operational areas supporting duals, serving as a liaison focused on alignment of LTSS initiatives, monitoring effectiveness and impact of programs, and facilitating development and implementation of program enhancements and new initiatives
- Collaborate with various operational functions such as enrollment, eligibility, care management, IT, claims, network, appeals/grievances, etc. to continually improve end to end member and LTSS provider support
- Collaborate with market and clinical leaders to address state-specific programmatic goals, tackle access to care challenges and build effective local partnerships
- Lead LTSS performance management/outcomes improvement/cost management activities
- Maintain national stakeholder relationships critical to thought leadership in LTSS innovation and policy
- Ability to successfully implement change amongst cross-functional teams
- Ability to synthesize and communicate program performance and outcomes
- Regular and predictable attendance

Required Qualifications
- 8+ years of experience in LTSS/HCBS program operations
- 5+ years management and/or organizational leadership
- Prior Medicaid LTSS and/or integrated Medicare Medicaid (MMP/FIDE) managed care experience
- Experience working with dual eligible and complex populations

COVID Requirements
COVID-19 Vaccination Requirement
CVS Health requires its Colleagues in certain positions 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, pregnancy, or religious belief that prevents them from being vaccinated.
  • If you are 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 within the first 30 days of your employment. For the two COVID-19 shot regimen, you will be required to provide proof of your second COVID-19 shot within the first 60 days of your employment. Failure to provide timely proof of your COVID-19 vaccination status will result in the termination of your employment with CVS Health.
  • If you are unable to be fully vaccinated due to disability, medical condition, pregnancy, or religious belief, you will be required to apply for a reasonable accommodation within the first 30 days of your employment in order to remain employed with CVS Health. As a part of this process, you will be required to provide information or documentation about the reason you cannot be vaccinated. If your request for an accommodation is not approved, then your employment may be terminated.

Preferred Qualifications
- Care management background preferred

Bachelor degree in related field required

Business Overview
At Aetna, a CVS Health company, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.

We are committed to maintaining a diverse and inclusive workplace. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, gender, gender identity, age, disability or protected veteran status. 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. See Job Description

, Illinois

Continue serving and work with a purpose

As a CVS Health colleague, you'll find career opportunities across the organization and at every stage of your career. More important, your work will have an impactful purpose on someone's life, including your own. Learn more about how you can continue serving on your next mission at CVS Health.

Careers for Veterans and Military Spouses


"The military has an ethos that is grounded in purpose-driven service that’s bigger than the individual. The same holds true for us at CVS Health. You can talk to colleagues in any part of our business and they will be able to articulate our company’s purpose. Working here provides an opportunity for service members and military spouses to continue to serve, just in a civvies."