Executive Director, DSNP Market Performance (NY/NJ/VA)

CVS Health•Whitpain Township, CT

30d•Hybrid

About The Position

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Role Overview At Aetna, our health benefits business, we are committed to helping our members achieve their best health in an affordable, convenient, and comprehensive manner. Combining the assets of our health insurance products and services with CVS Health’s unrivaled presence in local communities and their pharmacy benefits management capabilities, we’re joining members on their path to better health and transforming the health care landscape in new and exciting ways every day. Aetna is recruiting for an Executive Director who serves as a senior market executive with full accountability for the strategy, performance, and growth of Aetna’s Integrated Dual Eligible Special Needs Plans across the Northeast Territory. This role leads one of Aetna’s most strategically important markets and is responsible for financial outcomes, regulatory partnerships, and market execution for fully integrated Medicare–Medicaid products. As the primary executive liaison to state agencies and external stakeholders, the Executive Director builds durable, trust‑based relationships while driving profitable growth, regulatory compliance, and measurable improvement in member and provider experience.

Requirements

The candidate will have a strong work ethic, be a self-starter, and be able to be highly productive in a dynamic, collaborative environment.
15+ years of progressive leadership experience in managed care or healthcare, including direct responsibility for financial management.
Demonstrated P&L ownership with a strong financial and results orientation.
Deep expertise in integrated Medicare–Medicaid products, including DSNP/FIDE models.
Strong knowledge of health plan operations, medical management, quality and STARs performance, provider networks, NCQA accreditation, and regulatory compliance.
Proven ability to influence and lead within a complex, matrixed organization.
Skilled in leading, influencing, and motivating teams to achieve high performance and outcomes.
Strong executive presence, stakeholder management, and problem-solving skills.
Willingness to travel within the Northeast Territory as required.
Bachelor’s degree required

Nice To Haves

Experience managing relationships with state Medicaid regulators and government stakeholders.
Existing relationships within New Jersey, New York, and/or Virginia highly valued.
Prior engagement with community organizations serving dual‑eligible populations.
Ability to work Hybrid Model (in office Tuesday / Wednesday / Thursday).
advanced degree preferred

Responsibilities

Full ownership of financial performance, including budget attainment, margin improvement, and sustainable membership growth through disciplined revenue optimization, medical cost management, and administrative efficiency.
Set and execute market strategy to improve competitive position, quality outcomes (STARs), network performance, and operational effectiveness.
Serve as the senior executive relationship owner with state Medicaid agencies and regulators; represent plan interests with state officials, legislators, and industry associations.
Ensure full compliance with all federal and state requirements; oversee audit readiness and accountability for regulatory performance.
Lead local product design, bid development, and market intelligence efforts to support profitable growth, including oversight of supplemental benefits and delegated vendor partnerships.
Strengthen provider, community, and stakeholder relationships to enhance member experience and provider satisfaction.
Partner with Medicare, Medicaid, Duals segment leadership, and cross‑functional teams (network, clinical, quality, sales, marketing, operations) to deliver integrated results.
Build and develop a high‑performing leadership team; set clear performance expectations and invest in successor and talent development.
Lead readiness and execution for new contracts, programs, and expanded services.