Description

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.

Position Summary

The Senior Manager of Medicare DSNP Market will work alongside duals leaders to drive overall performance, compliance and health of the duals product for Aetna members eligible for Medicare and Medicaid services. Primary responsibilities include collaborating with internal and external partners to support growth, retention, engagement, and compliance efforts. This highly collaborative role requires effective cross-functional partnership with local markets, enterprise, and Government Services teams, as well as the DSNP Program Office, to achieve business goals while maintaining alignment with evolving requirements and standards

Position Duties & Responsibilities

• Ensure timely and accurate management of state-specific compliance requirements, including maintaining regulatory mailboxes, ensuring timely response to state inquiries, coordinating with state agencies, and supporting all required state-level reporting, submissions, and audits. Acts as the primary point of contact for state interactions related to DSNP compliance, proactively addressing issues and ensuring ongoing alignment with evolving state policies
• Understand product performance indicators to drive tactical improvements.
• Work with the sales and marketing teams to inform sales and member retention strategies to drive DSNP growth and optimize retention
• Provide training support to local sales teams to drive sales, community lead generation and membership growth
• Provide input and direction into product design and bid strategy
• Participate in DSNP Network design, service area expansion, compliance audits, evaluation of network adequacy, development of provider reimbursement and education strategies/programs and provider performance, quality, and engagement
• Guides development and review of member and provider facing materials
• Provide benefit education to the Care Team and offer support with member issues/trends to help improve member experience
• Supports the Dual Enrollee Advisory Committee meetings, reports on member feedback and help drive initiatives to improve member satisfaction
• Understand and translates requirements to ensure DSNP is compliant with state and CMS regulations
• Serve as subject matter expert regarding Medicaid policy for dual eligible in assigned market including but not limited to eligibility, Medicaid programs and services, benefits, etc.
• Act as trusted advisor and key resources for market related issues for Medicare corporate teams and local markets.
• Provide support to the health plan executive leadership with the administration of integrated duals products
• Provide support to DSNP Market Leads in the region as needed
• Other duties as assigned

Required Qualifications:

• 3+ years' experience in one or more of the following at a managed care or provider organization: DSNP programming, Managed Care Operations, Medicare Advantage
• Demonstrated relationship management skills; capacity to quickly build and maintain credible relationships at varying levels externally and within the organization simultaneously
• Strong organization skills, creativity, and member focused approach
• Proven track record understanding and applying requirements to assure compliance.
• Skilled and experienced at leading cross-functional work and teams and driving results around the organization.
• Ability to manage multiple priorities, identify trends independently and remediate gaps.
• Experiencing with product performance and tactically execution to drive results
• Experience with workflow and collaboration tools, including QuickBase and SharePoint
• Understanding of HPMS communications and related compliance requirements
• Strong written communication skills

Preferred Qualifications

• Experience with Duals Integrated Products
• Resident of the state of Illinois

Education

• Bachelor's degree or equivalent work experience

Pay Range

The typical pay range for this role is:

$82,940.00 - $182,549.00

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: 03/19/2026

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