Director Regulatory Affairs (Medicaid)

Job DescriptionAetna Better Health of Virginia is seeking a Director, Regulatory Affairs for its state-wide managed Medicaid business. This role is critical to ensure performance management and oversight of all requirements of our Medallion 4 and CCC+ contracts. This role will assist the Plan CEO in the successful growth and performance of the Plan. The role interfaces, collaborates, and works cooperatively with functional leaders and centralized shared services business departments on regulatory matters.Pay RangeThe typical pay range for this role is:Minimum: 100,000Maximum: 221,000Please 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.Required Qualifications 10+ years work experience that reflects a proven track record and knowledge of state of Virginia regulatory processes, government programs such as Medicaid, Medicare, or Dual Eligible including government affairs, legal, and an in-depth compliance background. Knowledge of state of Virginia regulatory processes Provide regulatory expertise and guidance based on state contractual requirements Provide performance management and adherence to state contract requirements. The ability to work collaboratively across many teams, prioritize demands from those teams, synthesize information received, and generate meaningful conclusions. Project manages implementation of state mandated MES IT initiative. Manage implementation of other state mandates. The individual must understand how compliance and quality programs (NCQA and HEDIS) affect the Plan. The ability to conceive innovative ideas or solutions to meet regulatory requirements. The individual must have excellent communication and relationship management skills and be able to express thoughts in an organized and articulate manner. The individual must be able to build a climate of trust and respect with regulators and our internal growth partners such as health services, service operations, and finance/actuarial personnel. The individual must have demonstrated leadership with meaningful initiatives such as: business process optimization, enterprise business project management/consulting, risk management. The individual must have recent and related managed health care experience. 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 stakeholdersCOVID RequirementsCOVID-19 Vaccination RequirementCVS 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.Preferred Qualifications Knowledge of state of Virginia regulatory processes Prior medicaid managed care experience Previous experience at Virginia Department of Medical Assistance ServicesEducationBachelor Degree required and Master Degree preferredBusiness OverviewBring your heart to CVS HealthEvery 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.

Created: 2025-11-15