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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, our health benefits business, we are committed to helping our members achieve their best health in an affordable, convenient, and comprehensive manner. 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.
Job Responsibility
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
Requirements
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
Nice to have
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)