Medical Director - National Medicare
HumanaFull Time
Expert & Leadership (9+ years)
Candidates must have at least 5 years of experience in public policy with a focus on state regulatory issues, especially Medicaid policy, or experience working directly with or within state regulatory agencies or state Medicaid programs. A demonstrated interest in improving healthcare outcomes, particularly for underserved populations or individuals on Medicaid, is required, along with experience in stakeholder engagement and coalition-building. The candidate must be based out of Virginia. Familiarity with state Medicaid programs and managed care regulations is preferred.
The Director of Regulatory Affairs will support the development and implementation of Aetna Better Health of Virginia’s state regulatory affairs and account management strategy, focusing on engagement with the Virginia Medicaid Agency. This role involves identifying, developing, and managing strategic relationships with state and local agencies, community-based organizations, and stakeholder advocacy groups. Responsibilities include monitoring state regulatory activity, assisting in the implementation of key state priorities, responding to regulatory inquiries, coordinating with coalitions, and representing the organization in discussions with regulatory agency staff. The Director will also oversee the implementation of key state initiatives, process state-level inquiries and complaints, draft formal responses to proposed rules and policies, and ensure internal business owners meet filing requirements for state regulatory reports. Additionally, the role involves tracking the implementation of laws and regulations relevant to Medicaid managed care, building relationships with state regulatory agencies, collaborating on educational resources for regulatory advocacy, monitoring and summarizing public regulatory meetings, and maintaining knowledge of national and state-specific trends affecting managed care organizations.
Comprehensive pharmacy and healthcare services
CVS Health operates a large network of retail pharmacies and walk-in medical clinics across the United States, providing a variety of health-related products and services. Their offerings include prescription medications, over-the-counter health products, and beauty items, as well as pharmacy benefits management and specialty pharmacy services. CVS Health's integrated business model allows them to serve individual consumers, businesses, and communities effectively, with a focus on improving health outcomes and reducing healthcare costs. Unlike many competitors, CVS Health combines pharmacy services with medical care, making it easier for patients to access quality healthcare. The company's goal is to enhance access to healthcare and support individuals in achieving better health.