Manager, Network Management (National LTSS Oversight)

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 part of the Network Integrity and Performance team this new position will engage with cross-functional teams and business partners across Aetna’s Medicaid and Medicare lines of business provide national (LTSS) Long term support service network oversight for the coordinated and integrated Special Needs products; DSNP, HIDE, & FIDE. The position will be responsible for oversight of the execution and adherence to the LTSS network strategy as defined by Aetna Medicaid leadership.  Critical thinking and decision-making skills are essential to the role.

This role is highly matrixed working with a variety of business and functional owners within the Aetna and Aetna Better Health (Medicaid) business units.

• Documenting and creation of a repository for the state level requirements for LTSS providers including provider types and adequacy
• Establish process to communicate any changes in state level requirements for LTSS providers across the local network teams
• Establish process to execute on Medicaid leadership LTSS network strategy and direction
• Coordination with the local network team responsible for LTSS contracting to ensure we meet adequacy and other state level requirements for LTSS provider types.
• Other duties as assigned and necessary for the implementation and maintenance the LTSS network for the integrated and coordinated Special Needs products; DSNP, HIDE, & FIDE.

Required Qualifications

• 3-5+ years managed care / health insurance industry experience related to high level project and initiatives.
• Multiple years of proven leadership experience setting strategic direction and influencing change that resulted in quantifiable positive outcomes.
• 2 -4 years project management experience- Proven track record managing complex projects and or programs.
• Knowledge & experience in both Medicaid and Medicare lines of business.
• Experience in QNXT, EPDB, excel, QuickBase

Preferred Qualifications

• Excellent business acumen skills, able to present to Market leadership
• Critical analytical thinking and problem solving
• Adept at execution and delivery (planning, delivering, and supporting) skills.
• Adept at collaboration and teamwork
• Detail oriented
• Medicare & Medicaid network/product contracting experience.

Education
Bachelor’s degree or equivalent professional experience

Anticipated Weekly Hours

Time Type

Pay Range

The typical pay range for this role is:

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. 
 

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

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.