Position SummaryThe Lead Director, Healthcare Affordability Strategy is a key leadership position driving ideation and execution of critical affordability initiatives throughout the Aetna enterprise. This role will report directly to the Executive Director, Affordability Program Management and be responsible for leading key initiatives across the Network, Clinical and Med Affairs teams across all three lines of business, Commercial, Medicare and Medicaid.
This role also partners with the Medical Economics Unit to identify rising healthcare costs and implement initiatives that address underlying causes of trend drivers. The Lead Director will own, manage and be responsible for a portfolio of initiatives aimed at improving affordability for members and customers. The position also collaborates with Medical and Clinical Directors to examine trends and develop initiatives that address the identified root causes.
Role Responsibilities:
- Experience project managing large scale cross-functional teams with Provider Network, IT, clinical and UM/CM functions. Experience building and designing 300+ line project plans and its subsequent management.
- Experience with interoperability and EMR systems a plus
- Owns the ideation management and execution of key initiatives, working across business teams to identify opportunities and collaborate with MEU and other teams to size opportunities and drive them to execution
- Will lead and own the workgroups and teams that will ideate on potential savings initiatives, including monthly updates to executive leadership on status, risks, gaps and outcomes
- Will be able to lead teams of 10+ colleagues, including the potential for direct reports
- Must be able to collaborate and build relationships with like leaders within the CVS enterprise to build out capability and support models in affordability.
- Has a strong, project management and execution focused personality
- Develops a detailed work plan that highlights major milestones to manage delivery schedules and monitors progress to ensure that milestones are achieved throughout the project.
- Approves project plans, budgets, and deliverables, ensuring alignment with organizational objectives and stakeholder expectations.
- Facilitates collaboration across various functions: Engages with clinical operations, provider networks, analytics, and finance teams to ensure the successful implementation of cost of care programs, emphasizing scalability, operational excellence, analysis of external partners, and enhancement of value-based contract performance.
- Conducts analyses of financial impact and return on investment.
- Leads strategic problem-solving and ongoing process enhancement: Champions initiatives to improve cost management practices within the Aetna Clinical Solutions Performance Management team, promoting a culture of continuous improvement through innovative solutions and data-driven strategic problem-solving.
- Proactively identifies significant project risks, formulates mitigation strategies, escalates issues to leadership, and implements approved mitigation measures.
- Coordinates clinical project teams and manages their interdependencies across various projects and programs within the organization.
- Provides oversight for key strategic projects, ensuring that the final outcomes align with business objectives, established metrics, and that all deliverables and deadlines are met.
- Collaborates with data informatics and Information Services as necessary to guarantee accuracy, integrity, validity, reliability, and consistency in report preparation and distribution.
- Creates and own the presentation of PowerPoint and other presentation materials to senior leadership as well as ongoing workgroup updates.
- Owns the responsibility of timelines and milestones for all initiatives in their portfolio, engages project management support as needed and drives to execution.
- Is responsible for the outcomes and completion of all projects in their portfolio.
- Adept at development, execution and delivery (planning, delivering, and supporting) skills
- Adept at business intelligence, collaboration, and teamwork
- Mastery of problem solving, decision making, and growth mindset
- Strategic thinker with a hands-on approach to execution in a regulated healthcare setting.
- Proven ability to work independently, manage multiple complex priorities, and deliver results in a fast-paced, dynamic environment.
Required Qualifications- 10+ years of experience within a health plan, with a strong understanding of payer operations and healthcare delivery models.
- 3-5 years of experience in provider network management, provider engagement, and healthcare data analysis.
- Demonstrated project management expertise, including project planning, stakeholder coordination, risk identification, issue resolution, and ensuring successful execution of complex initiatives.
- Working knowledge of Electronic Medical Record (EMR) systems and their integration within healthcare operations.
- Exceptional facilitation, communication, and relationship management skills, with the ability to influence and collaborate effectively across clinical, operational, and technology teams.
- Advanced proficiency in Microsoft Office applications, including Excel, PowerPoint, Teams, and other collaboration tools.
- Proven ability to synthesize complex information, develop actionable insights, and drive cross-functional initiatives to successful outcomes.
Preferred Qualification- Project Management Professional (PMP) certification or equivalent project management credential.
- Master's degree in Healthcare Administration, Business Administration, Public Health, Information Systems, or a related field.
- Experience working with Aetna systems, processes, and provider network operations.
- Demonstrated knowledge of health plan technology platforms, provider data management, and operational workflows within a payer environment.
Education- Bachelors degree preferred or a combination of work experience and education.
Pay RangeThe typical pay range for this role is:
$100,000.00 - $231,540.00
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.
Great benefits for great peopleWe take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.
This full-time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well-being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.
Additional details about available benefits are provided during the application process and on Benefits Moments.
We anticipate the application window for this opening will close on: 09/05/2026
