At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day. **Position Summary** Aetna Better Health is Aetna’s Medicaid managed care plan. Backed by over 30 years of experience managing the care of those with a broad array of health care needs, our Medicaid plans have demonstrated that getting the right help when you need it is essential to better health. That’s why Aetna® Medicaid plans include the guidance and support needed to connect our members with the right coverage, resources, and care. We are focused on enhancing quality and population health outcomes while integrating CVS assets to bring accessible healthcare to our members. Aetna is recruiting for an Executive Director, Supporting Kentucky Youth (SKY) who is a key member of the Aetna Better Health of Kentucky leadership team, serving as a peer to the health plan COO, CFO and CMO in ensuring our Supporting Kentucky Youth line of business functions in an optimal manner in the Kentucky Medicaid market. This leader is responsible for the oversight and management of the SKY business. Operating in a matrixed organization, this leader directs a large “dotted line” team of care managers, quality of care staff, and provider relations staff. This Executive Director is responsible for developing and nurturing relationships with SKY and health plan stakeholders, including but not limited to state regulators, providers, community partners, parents and caretakers for system involved children. You’ll make an impact by: + Implementing and administrating of the Kentucky SKY Contract. + Collaborating with executive leadership throughout the organization to develop and implement program strategies that meet business, CMS, federal and state regulations as well as accrediting agency requirements. + Creating and maintaining collaborative partnerships with key accounts (large medical groups, hospital providers), working to establish collaborative relationships by fostering excellent customer response and appropriate problem resolution. + Leading a team that promotes high standards of operational practice through advancement of policies, procedures, practice guidelines and alignment of clinical and business processes and practices. + Responsibility for cross-functional integration of care and case management, utilization management, program operations with core organization-wide business functions including claims, member services, compliance, quality, and network/provider services. + Responsibility for cost savings and quality improvement projects through successful implementation. + Leading and managing all aspects of projects and/or programs. Ensuring the use of a formal project plan and collaborative workgroups are used in demonstrating the achievement of the project implementation goals. + Consulting and supporting the utilization management processes by encouraging the use of industry best practices and standards. + Responsibility for relationship management for vendors; ensuring targets are achieved and medical management and operational goals are met. + Establishing a positive organizational culture as experienced by Aetna colleagues, members, providers, and external stakeholders. + Identifying and executing strategic partnerships to improve member outcomes. + Establishing the business unit’s clinical strategic vision and objectives. + Serving as the health plan SME and key clinical lead in developing and implementing evidence-based clinical policies and practices at both the health plan and clinical practice levels. This will require the integration of relevant pharmacy and social data to inform clinical policies and practices. + Participating in management and program improvement activities with key staff for enhanced integration of physical health and behavioral health services and achievement of outcomes. + Facilitating integration of care coordination, behavioral health, and chemical dependency programs. + Developing and overseeing implementation of initiatives to achieve budgeted reductions in medical expenses and increases in quality scores. + Using analytics to identify key insights about the populations served and drive the development of the interventions to target unique populations. + Representing the Kentucky health plan as the clinical and children’s specialty SME for enterprise RFP and implementation activities. **Required Qualifications** The candidate will have a strong work ethic, be a self-starter, and be able to be highly productive in a dynamic, collaborative environment. This position offers broad exposure to all aspects of the company’s business, as well as significant interaction with all the business leaders. The candidate will be expected to have the following key attributes: + 10+ years of experience in managed care, preferably in Medicaid. + Deep experience or knowledge of the Foster Care and Juvenile Justice Systems, Adoption Assistance, the delivery of Behavioral Health Services, Trauma-informed Care, ACEs, Crisis Intervention Services, and evidence-based practices applicable to the Kentucky SKY populations. + 5‐7 years of experience in management or clinical leadership. + Effectively lead and motivate teams in a collaborative nature to ensure high standards of performance and outcomes. + Knowledge of medical management regulations, standards, and policies. + Ability to synthesize program performance and clinical outcome. + Strong analytical and critical thinking skills. Focus on driving disciplined, fact-based decisions, and executing with discipline and urgency. + Ability to evaluate and interpret data for the purpose of developing new programs and processes to meet business demands. + Expertise with influencing and navigating a highly matrixed environment. + Strong relationship building skills with external client partners such as the Department of Medicaid and/or Department of Community Based Services. + Demonstrated experience at a strategic thinker with executive presence. + Ability to work Hybrid Model (in office Tuesday / Wednesday / Thursday) in the Louisville, Kentucky office, or remote work arrangement for those outside of the Louisville office geography. Position must reside in Kentucky due to Medicaid contract. Relocation assistance may be provided for the right candidate. **Education** Bachelor’s degree is required; Behavioral Health or other clinical licensure preferred. **Pay Range** The typical pay range for this role is: $131,500.00 - $303,195.00 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. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. **Great benefits for great people** We take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include: + **Affordable medical plan options,** a **401(k) plan** (including matching company contributions), and an **employee stock purchase plan** . + **No-cost programs for all colleagues** including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. + **Benefit solutions that address the different needs and preferences of our colleagues** including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit https://jobs.cvshealth.com/us/en/benefits We anticipate the application window for this opening will close on: 06/27/2025 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. We are an equal opportunity and affirmative action employer. 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.