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Join a Purpose‑Driven Leader in Healthcare: CVS Health & Aetna Better Health
At CVS Health, we live by a single, powerful purpose – “Bringing our heart to every moment of your health.” This purpose shapes every interaction, product, and service we deliver, ensuring that care is not just clinical, but compassionate, convenient, and affordable. As the parent company of Aetna Better Health of Illinois (ABHIL), we operate one of the nation’s most respected Medicaid managed‑care plans, built on more than three decades of expertise in serving diverse populations with complex health needs.
Our vision is bold: to transform how Medicaid members experience healthcare by integrating cutting‑edge technology, evidence‑based clinical programs, and a relentless focus on social determinants of health. We are seeking an inspiring, strategic leader who will champion this vision as our Chief Health Services Officer (CHSO). If you thrive in a remote, high‑impact environment, love shaping policy‑driven programs, and want to make a measurable difference for Illinois families, this is your opportunity.
Why This Role Is a Game Changer
The CHSO is a senior executive who sits at the heart of ABHIL’s leadership team, reporting directly to the CEO and partnering closely with the COO, CFO, and CMO. You will be the strategic and operational mastermind behind all medical‑management functions—Utilization Management, Care Management, Behavioral‑Physical health integration, Quality Improvement, and Social‑Determinant initiatives. Your decisions will shape the health outcomes of hundreds of thousands of Medicaid members across Illinois, directly influencing state‑wide health metrics, compliance scores, and member satisfaction.
Core Responsibilities – Driving Excellence Across the Health Services Spectrum
- Strategic Leadership: Define and execute a multi‑year health‑services roadmap that aligns with Aetna Better Health’s market goals, regulatory requirements, and CVS Health’s broader corporate strategy.
- Operational Oversight: Lead the centralized medical‑management teams, ensuring optimal staffing, performance metrics, and continuous process improvement across Utilization Management (UM), Care Management (CM), and related programs.
- Regulatory Stewardship: Serve as the single point of contact (SPOC) for all health‑services regulatory matters, maintaining compliance with Illinois Medicaid contracts, HEDIS standards, and accreditation bodies.
- Quality Management: Partner with the Quality team to drive superior HEDIS performance, implement robust quality‑measurement frameworks, and secure necessary accreditations.
- Program Development & Integration: Design, launch, and evaluate innovative care programs—including behavioral health integration, chronic disease management, and Social Determinants of Health (SDOH) initiatives—ensuring they are evidence‑based and financially sustainable.
- Vendor & Partner Collaboration: Oversee clinical‑program vendor implementations, nurture relationships with external clinical stakeholders, and ensure seamless integration with internal systems.
- Data‑Driven Decision Making: Leverage advanced analytics to monitor population health trends, identify gaps in care, and inform strategic adjustments.
- Stakeholder Communication: Translate complex clinical concepts into clear, compelling presentations for senior leadership, state officials, and external partners.
- RFP Leadership: Represent ABHIL as the health‑services subject matter expert during all plan‑specific Request‑for‑Proposal (RFP) activities.
- Diversity, Equity, and Inclusion (DEI) Advocacy: Champion DEI initiatives within the health‑services function, ensuring that workforce composition reflects the communities we serve.
Essential Qualifications – The Foundations of Success
- Minimum 10 years of progressive leadership experience in medical management within a managed‑care environment.
- At least 5 years of direct Medicaid experience, preferably within the State of Illinois, with a proven record of navigating state contracts, reporting obligations, and compliance frameworks.
- Demonstrated expertise in developing, implementing, and evaluating utilization and care‑management programs at scale.
- Strong analytical background with hands‑on experience in data‑analytics reporting, population health metrics, and performance‑improvement methodologies.
- Exceptional executive‑level presentation skills, capable of influencing senior leaders, state officials, and external partners.
- Proven ability to lead cross‑functional, matrixed teams, driving innovation and collaborative problem‑solving.
- Robust decision‑making, organizational, and strategic planning capabilities.
- Commitment to DEI principles, with a track record of fostering inclusive workplace cultures.
Preferred Qualifications – What Sets Candidates Apart
- Current or former Registered Nurse (RN) license, preferably obtained in Illinois.
- Residency in Illinois, reinforcing deep familiarity with local health‑policy dynamics.
- Direct experience engaging with state Medicaid agencies on contract negotiations, compliance audits, and performance reporting.
- Advanced degree (e.g., Master of Health Administration, MBA, MPH) or specialized certifications (e.g., CCM, CPHQ).
Key Skills & Competencies – The DNA of Our Ideal Leader
- Strategic Vision: Ability to see the big picture while translating it into actionable, measurable initiatives.
- Influence & Collaboration: Skillful at building consensus across senior leadership, clinical teams, and external stakeholders.
- Analytical Acumen: Proficiency with statistical tools, predictive modeling, and health‑economics concepts.
- Change Management: Expertise in guiding organizations through transformation, technology adoption, and process redesign.
- Regulatory Savvy: In‑depth knowledge of Medicaid regulations, HEDIS, NCQA, and other accreditation standards.
- Communication Excellence: Clear, concise, and compelling storytelling for diverse audiences.
- People Development: Passion for mentoring, coaching, and cultivating high‑performing teams.
Career Growth & Learning – Your Path to Executive Impact
At CVS Health, we invest heavily in talent development. As CHSO, you will gain unparalleled exposure to:
- Executive leadership boards shaping nationwide health‑policy initiatives.
- Cross‑functional mentorship programs with senior executives across the CVS Health portfolio.
- Advanced educational resources, including tuition assistance, industry‑leading certifications, and internal leadership academies.
- Opportunities to lead high‑visibility, multi‑state projects that can influence the future of Medicaid care.
Our commitment to continuous learning ensures that you remain at the forefront of emerging trends—digital health, value‑based care, AI‑driven analytics, and more.
Culture & Work Environment – A Remote Workforce Powered by Heart
While the role is fully remote, you will be an integral part of a vibrant, purpose‑driven community. Our culture is built on three pillars:
- Heart‑Centered Care: Every decision is filtered through the lens of empathy for our members and teammates.
- Innovation & Agility: We champion bold ideas, rapid prototyping, and data‑backed experimentation.
- Inclusion & Belonging: Diverse perspectives are not just welcomed—they’re essential to our success.
Remote employees enjoy flexible schedules, collaborative virtual workspaces, and regular in‑person meet‑ups at regional hubs to foster connection.
Compensation, Perks & Benefits – Recognizing Your Value
We offer a competitive salary range of $100,000 – $231,540, complemented by a robust total rewards package that includes:
- Annual performance‑based bonus and short‑term incentive potential.
- Equity awards through CVS Health’s stock‑award program.
- Comprehensive medical, dental, and vision coverage for you and eligible dependents.
- Employer‑matched 401(k) retirement plan and an Employee Stock Purchase Plan (ESPP).
- Fully paid term life insurance, short‑term and long‑term disability protection.
- Generous paid time off (PTO), paid holidays, and sick leave in accordance with state law.
- Well‑being programs, mental‑health resources, and fitness‑related stipends.
- Education assistance, free development courses, and tuition reimbursement.
- Employee discounts at CVS retail locations and partner organizations.
Our benefits are designed to support you holistically—physically, financially, and personally.
How to Apply – Take the Next Step Toward Transformative Leadership
Ready to bring your expertise, passion, and strategic mindset to a role where you can truly shape the health of Illinois Medicaid members? Submit your application by December 31, 2024. We welcome candidates who may not meet every listed requirement but demonstrate the drive, curiosity, and collaborative spirit essential to our mission.
Don't hesitate—apply today and join a team that puts its heart into every moment of health.
Application Instructions
Click the link below to begin your application process. Attach an updated resume, a cover letter highlighting your relevant experience, and any supporting documentation (certifications, publications, etc.) that showcase your leadership in health services.
Apply Now – Chief Health Services Officer (Remote)
Closing Statement – Your Impact Starts Here
At CVS Health, we believe that leadership is not just about titles—it’s about heart. As the Chief Health Services Officer for Aetna Better Health, you will be the catalyst for innovative, compassionate, and equitable care for thousands of Medicaid families. If you’re ready to lead with purpose, drive measurable health outcomes, and grow alongside an industry‑leading organization, we look forward to welcoming you to our team.
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