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COMPLETE Sr Manager, DSNP Market NY/NJ based - NJ - Princeton

9 days ago


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Job Opportunity Details

Type

Full Time

Salary

Not Telling

Work from home

No

Weekly Working Hours

Not Telling

Positions

Not Telling

Working Location

Princeton-3 Independence Way, NJ - Princeton, United States   [ View map ]

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.

Position Summary

The Sr. Manager will work alongside duals leaders to drive overall performance for duals products. The Sr. Manager’s primary responsibilities will include working with the sales and marketing teams on retention, growth and community engagement; assisting with the CMS bid process which includes benefit design, competitive analysis and material review; educate internal stakeholder on DSNP; and facilitate member engagement initiatives, including Enrollee Advisory Committee meetings.  The Sr. Manager will also support performance oversight in various other areas as needed (STARs, clinical, quality, financial, compliance and network).   This is a highly collaborative role requiring ability to work effectively cross-functionally with local markets, enterprise, and Government Services teams as well as the DSNP Program Office to drive results and deliver on strategic year over year growth goals. 

 Position Duties & Responsibilities

  • Supports growth and expansion initiatives, including competitive analysis.
  • Understand product performance indicators to drive tactical improvements.
  • Works with the sales and marketing teams to establish sales and member retention strategies to drive DSNP growth and optimize retention

  • Provides training to local sales teams to drive sales, community lead generation and membership growth
  • Provides input and direction into product design and bid strategy
  • Participates 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 facing materials
  • Provide benefit education to the Care Team and offer support with member issues/trends to help improve member experience
  • Organizes and facilitates the Dual Enrollee Advisory Committee meetings, reports on member feedback and help drive initiatives to improve member satisfaction
  • Understands and translates requirements to ensure DSNP is compliant with state and CMS regulations
  • Serves as subject matter expert regarding Medicaid policy for dual eligibles in assigned market including but not limited to eligibility, Medicaid programs and services, benefits, etc.
  • Acts as trusted advisor and key resources for market related issues for Medicare corporate teams and local markets.

Provides support to the Chief Duals Officer with the administration of integrated duals products

  • Provides support to DSNP Market Leads in the region as needed
  • Other duties as assigned

Required Qualifications:

  • Must live within 100 miles of territory
  • 6+ years’ experience in one or more of the following at a managed care or provider organization: DSNP programs, 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

Preferred Qualifications

  • Resident of NY/NJ
  • Experience with Medicaid Advantage Plus (MAP) and Medicare Advantage (FIDE) Dual Special Needs Plans

Education

  • Bachelor’s Degree or equivalent experience

Pay Range

The typical pay range for this role is:

$79,200.00 - $170,800.00


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. 
 
In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities.  The Company offers a full range of medical, dental, and vision benefits.  Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees.  The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners.  As for time off, Company employees enjoy Paid Time Off (“PTO”) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies. 
 
For more detailed information on available benefits, please visit jobs.CVSHealth.com/benefits

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.

CVS Health is committed to recruiting, hiring, developing, advancing, and retaining individuals with disabilities. As such, we strive to provide equal access to the benefits and privileges of employment, including the provision of a reasonable accommodation to perform essential job functions. CVS Health can provide a request for a reasonable accommodation, including a qualified interpreter, written information in other formats, translation or other services through ColleagueRelations@CVSHealth.com If you have a speech or hearing disability, please call 7-1-1 to utilize Telecommunications Relay Services (TRS). We will make every effort to respond to your request within 48 business hours and do everything we can to work towards a solution. 


More Information

Application Details

  • Organization Details
    4062 Aetna Resources, LLC
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