Director, Duals LTSS

Job DescriptionAs part of the Duals Program Office team, the Director of Duals LTSS will focus on the innovation and design of LTSS and other home-based services, including the strategic alignment of LTSS initiatives into a cohesive program. You will identify opportunities to enhance capabilities to manage the LTSS needs of clinically and socially complex dual eligible populations. You will be responsible for working cross-functionally across the enterprise and segment clinical teams supporting duals. Leader serves as a liaison focused on facilitating development and implementation of program enhancements and new initiatives that promote the effectiveness and impact of LTSS programs and in-home supplemental benefits. Fundamental Components Serve as a liaison and leader supporting the Medicare Duals segment and the advancement of LTSS programs and services to support duals outcomestCollaborate with executive leadership throughout the organization to assess current capabilities and identify opportunities for improvement Plan, design, and monitor through an iterative process an end-to-end LTSS program that defines the value story. Leverage best in class protocols that successfully support members in the safest, least restrictive setting of choice resulting in improved health outcomes, increased independence, and member satisfaction Develop and implement improvements to existing LTSS programs. Areas may include development of tool sets, enhanced integration of SDoH, development or support of training needs, improving approach to analytics and reporting, establishment of new vendor relationships and development or enhancement of community partnerships Ensure all LTSS program needs align with business needs, federal/state regulations, and accrediting agency requirements Work with clinical and other operational areas supporting duals, serving as a liaison focused on identification and alignment of program initiatives. For example, structuring MSA's, collaborating with functional partners to implement program enhancement/initiatives, developing metrics and monitoring effectiveness and impact of programs through standardized reporting formats Collaborate with various operational functions such as enrollment, eligibility, care management, IT, claims, network, appeals/grievances, etc. to continually improve end to end member and LTSS provider support Maintain national stakeholder relationships critical to thought leadership in LTSS innovation and policy Consult on design for supplemental benefits targeting in-home supportive services and caregiver supportPay RangeThe typical pay range for this role is:Minimum: 100,000Maximum: 227,000Please 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 Experience implementing change amongst cross-functional teams. 8+ years of experience in LTSS/HCBS program operations 5+ years management and/or organizational leadership Prior Medicaid LTSS and/or integrated Medicare Medicaid (MMP/FIDE) managed care experiencePreferred QualificationsN/AEducationA Bachelor's Degree or 12 years of equivalent work experienceBusiness OverviewBring 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. 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. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.

Created: 2025-11-15