Senior Manager, Integrated D-SNPs

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.

At Aetna®, part of CVS Health, we proudly serve more than 26 million medical members through our broad range of health plan offerings. We're committed to delivering a simpler, more meaningful, and personal health care experience to each of them.

As a Senior Manager, Integrated D-SNPs, you will play a critical role in supporting our Aetna members and our business by being a driving force within Aetna’s Medicare Organization’s National Duals Program Office which sets the strategy for the company’s Dual-Eligible Special Needs Plan (D-SNP) program and manages its Institutional Special Needs Plan (I-SNP) program and Special Needs Plan (SNP) training.

As the Senior Manager of Integrated D-SNPs, you will focus on items pertaining to the integration of Medicare and Medicaid. You will have a dotted line to the National Duals Program Office’s Lead Director of Medicaid Policy and support projects from conception to execution and ongoing maintenance.

You will also collaborate with the National Duals Program Office’s Special Needs Plan Trainer and serve as a subject matter expert for reviews of content focused on items such as: D-SNPs (Coordination-Only, Highly Integrated, and Fully Integrated), Applicable Integrated Plans, Lessor-Of payment methodologies, the Medicare Savings Program, etc.

This role also includes partnering with internal Medicaid stakeholders on workgroups and other tasks focused internal Medicaid and Medicare alignment opportunities. You will also help identify and address opportunities for collaborations involving D-SNP and Medicaid and support execution of deliverables for a Duals Governance Committee.

As Senior Manager of Integrated D-SNPs you will also support Aetna’s D-SNP Market Leads as they navigate nuances of Medicaid contracts and regulators for their assigned D-SNP states. You will also support the National Duals Program Office’s Senior Manager of D-SNP Operations in the development and maintenance of department policies and procedures and reviews of external vendors for services tailored towards dual-eligibles.

Fundamental Job Components

• Keep abreast of regulatory policies and updates pertaining to D-SNPs and communicate those as appropriate to key internal partners.
• Serve as subject matter expert regarding highly integrated and fully integrated D-SNPs
• Understand and translate regulatory requirements to ensure D-SNP is compliant with state and CMS regulations
• Serve as National Duals Program Office SME for internal D-SNP and SNP implementation support / Assist with cross-functional work collaborations/model creation
• Support the review of contracts required for the course of business
• Develop playbooks, presentations, policies, and procedures
• Provide support to D-SNP Market Leads to help navigate Medicaid intricacies in their assigned D-SNP states
• Represent National Duals Program Office for Medicaid requests for proposals (RFPs) where D-SNP presence is requested
• Collaborate with Medicaid partners to identify, design, and implement integrated and aligned D-SNP solutions
• Attend Medicare Market bid meetings for insight into D-SNP changes and to communicate National strategies for alignment
• Support prompt turnaround of executive leadership requests by developing/delivering data, presentations, etc.
• Gather, synthesize, and present critical information in a concise format to facilitate efficient decision-making. This includes creating presentations for executive and senior-leadership audiences
• Operate effectively in ambiguous or evolving environments, exercising sound judgment to make appropriate, timely decisions.
• Work independently and consistently meet or exceed deliverables

Required Qualifications

• 3+ years working with Medicare/D-SNP and/or Medicaid programs
• Experienced and knowledgeable regarding Medicare/D-SNP and Medicaid regulations and programs
• Previous experience working cross-functionally within a highly matrixed health plan or managed care organization
• Strong problem-solving and decision-making skills
• Excellent verbal and written communication and presentation skills

Preferred Qualifications

• We support a hybrid work environment. If selected and you live near a suitable work location, you may be expected to comply with the hybrid work policy. Under the policy, all hires for in-scope populations should be placed into a hybrid or office-based location, working onsite three days a week. Aetna Service Operations office/hub locations will be discussed with the selected candidate

Education

• Bachelor’s degree or equivalent work experience

Pay Range

The typical pay range for this role is:

$75,400.00 - $165,954.00

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.  This position also includes an award target in the company’s equity award program. 
 

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

We anticipate the application window for this opening will close on: 04/08/2026

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