As the Director, Health Equity and Regulatory Affairs you will be responsible for the strategic leadership for driving health equity and regulatory affairs activities and processes that contribute to the performance of the market and promotes quality of care for our members. These responsibilities include product development, business development, relationship management with state regulator, business growth and retention and enhancing relationships with providers and facilities, regulatory agencies, and other internal and external stakeholders.
• Acts as a key business partner in business development, network development, product design, strategic planning, regulatory compliance, and business development
• Drives the strategic agenda and shifts direction as the market conditions dictate by understanding industry issues, trends, and the regulatory landscape, utilizing and interpreting data and demonstrating strong storytelling and ability to establish and maintain stakeholder relationships
• Provides strategic direction in the development and implementation of products, programs, tactics and polices that impact health care equity, quality, cost and outcomes to include utilization management, care management and quality management
• Responsible for recommending changes and enhancements to current managed care, review guidelines, and clinical criteria through the health equity lens based on extensive knowledge of health care delivery systems
• Guides, develops, and implements enhanced collaborative health care equity arrangements and new collaborative models of care.
• Provides strategic direction to the market on all regulatory affairs through a health equity lens collaborating across the highly matrixed environment.
• Provides leadership, oversight and monitors all relationship management with the state agency customer
• Recommends changes to Aetna's health equity initiatives and activities to address members needs across the continuum of care
• Oversight and leadership of community outreach teams focused on supporting health equity initiatives and activities
The typical pay range for this role is:
Please keep in mind that this range represents the pay range for all positions in the job grade within which this position falls. The actual salary offer will take into account a wide range of factors, including location.
• 10 years of healthcare experience
• 5-8 years of Medicaid experience, preferably in regulatory/legislative affairs, clinical and/or network, or consulting
• Demonstrated compliance with Federal and State laws and regulations
• Demonstrated communication/interpersonal skills and ability to partner with Aetna management, outside counsel, legislators, elected/appointed officials, regulators, staff of trade associations and other key stakeholders
• Strong skills in analyzing, understanding, and translating complex legislative, regulatory and policy issues to advise on pending legislation, regulations, changes in key government policy and other government relations matters pertinent to the Company
• Experience and leadership in working with and representing State accounts
• Demonstrated ability to develop and maintain highly successful working relationships with state officials, legislators, regulators, associations and other groups important to advocacy efforts.
• Experience in a corporation with a matrixed government and regulatory affairs structure
COVID-19 Vaccination Requirement
CVS Health requires certain colleagues 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, religious belief, or other legally recognized reasons that prevents them from being 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 or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.
Experience with regulatory affairs in the state of Illinois
Bachelors degree or 14 years of equivalent work experience
Bring your heart to CVS Health
Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as what we deliver.
Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.
We strive to promote and sustain a culture of diversity, inclusion and belonging every day.
CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.