Talent.com
Lead Director, Medicare Member Journey Orchestration Center of Excellence
Lead Director, Medicare Member Journey Orchestration Center of ExcellenceMaryland Staffing • Annapolis, MD, US
Lead Director, Medicare Member Journey Orchestration Center of Excellence

Lead Director, Medicare Member Journey Orchestration Center of Excellence

Maryland Staffing • Annapolis, MD, US
1 day ago
Job type
  • Full-time
Job description

Lead Director, Medicare Member Journey Orchestration

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. The Lead Director, Medicare Member Journey Orchestration Center of Excellence will bring deep expertise in Medicare operations, project management, governance, and data-driven decision-making to enhance member experience and deliver strong STARS performance. In this role, you will develop the strategy and roadmap to streamline and optimize Medicare-related processes to advance a seamless, highly personalized engagement across our member's unique journey. You will lead cross-functional governance processes and workstreams through strong collaboration to ensure transparency and alignment while delivering industry-leading STARS performance. Establish a strong methodology to deliver on tight timelines while consistently evaluating cutting-edge innovation to further advance our organization.

Fundamental Job Components

  • Lead cross-business governance for Medicare-specific functions, ensuring alignment.
  • Develops and manages a high-performing team.
  • Design workstreams to execute the Medicare specific stages of the defined engagement strategy.
  • Oversee project management activities, ensuring timely delivery and alignment with strategic goals.
  • Coordinate governance activities with Aetna, CVS Health and other external partners.
  • Develops the processes to maintain and manage a comprehensive Medicare communication inventory.
  • Identify and implement process efficiencies, including automation and digital transformation.
  • Communicates internal and external opportunities with leadership for risk mitigation or innovation.
  • Develops and presents ROI-driven insights and member engagement stories to stakeholders.
  • Establishes the strategy to engage internal leadership / colleagues on the member engagement strategy.
  • Monitor and analyze operational metrics to inform strategy and improve outcomes.
  • Develop and manage budgets for engagement initiatives.
  • Ensure optimal resource allocation and cost-effectiveness across projects and programs.

Required Qualifications

  • 10+ years of experience in Medicare operations, healthcare management, or related fields.
  • Skilled in planning, executing, and supporting complex initiatives.
  • Proficient in automation tools and digital engagement platforms.
  • Strong collaborator with proven teamwork and stakeholder management abilities.
  • Demonstrates a growth mindset through continuous learning and talent development.
  • Excellent communicator with advanced analytical and strategic thinking skills.
  • Experienced in vendor and partner engagement within healthcare settings.
  • Well-versed in STARS ratings and effective member engagement strategies.
  • Preferred Qualifications

  • Deep understanding of Aetna systems and governance frameworks.
  • Education

    Bachelor's degree or equivalent work experience.

    Pay Range

    The typical pay range for this role is : $100,000.00 - $231,540.00 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.

    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 : 11 / 02 / 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.

    Create a job alert for this search

    Director • Annapolis, MD, US

    Related jobs
    Senior Director of Health Partnerships

    Senior Director of Health Partnerships

    VirtualVocations • Baltimore, Maryland, United States
    Full-time
    A company is looking for a Senior Director, Health Plan Partner Sales to manage and grow partnerships with health plans.Key Responsibilities Manage relationships with assigned health plans, ensur...Show more
    Last updated: 4 days ago • Promoted
    State Licensed Senior Medical Director

    State Licensed Senior Medical Director

    VirtualVocations • Baltimore, Maryland, United States
    Full-time
    A company is looking for a Senior Medical Director of Geriatric Psychiatry Services.Key Responsibilities Lead and oversee psychiatric teams providing telehealth care to older adults with serious ...Show more
    Last updated: 30+ days ago • Promoted
    Client Success Director

    Client Success Director

    VirtualVocations • Baltimore, Maryland, United States
    Full-time
    A company is looking for a Client Success Director - Periop and Patient Care Coordination.Key Responsibilities Lead and develop a team of Client Success Partners, focusing on accountability and s...Show more
    Last updated: 30+ days ago • Promoted
    Washington Licensed Medical Director

    Washington Licensed Medical Director

    VirtualVocations • Baltimore, Maryland, United States
    Full-time
    A company is looking for an Internist, ABIM / AOBIM Medical Director (Remote / Full Time).Key Responsibilities : Conduct regular case reviews to ensure compliance with CMS NCD / LCD guidelines Assist i...Show more
    Last updated: 3 days ago • Promoted
    Director of Patient-Centered Outcomes

    Director of Patient-Centered Outcomes

    VirtualVocations • Baltimore, Maryland, United States
    Full-time
    A company is looking for a Senior Director / VP, Patient-Centered Outcomes.Key Responsibilities Provide strategic and scientific guidance on clinical outcome assessments (COAs) to internal and exte...Show more
    Last updated: 20 hours ago • Promoted • New!
    Senior Medical Director

    Senior Medical Director

    VirtualVocations • Baltimore, Maryland, United States
    Full-time
    A company is looking for a Senior Medical Director, Clinical Development.Key Responsibilities : Supports the development of clinical trial protocols and oversees the conduct of clinical trials Pr...Show more
    Last updated: 30+ days ago • Promoted
    Director of Residence Life

    Director of Residence Life

    InsideHigherEd • Bowie, Maryland, United States
    Full-time
    JR101449 Director of Residence Life (Open).The Residence Life program at Bowie State University serves the needs of approximately 1700 residents. We are committed to supporting the academic mission ...Show more
    Last updated: 3 days ago • Promoted
    Medical Director - Family Medicine

    Medical Director - Family Medicine

    VirtualVocations • Baltimore, Maryland, United States
    Full-time
    A company is looking for a UM Medical Director specializing in Family Medicine, Internal Medicine, or Sports Medicine, to work remotely. Key Responsibilities : Conduct coverage reviews and render c...Show more
    Last updated: 3 days ago • Promoted
    DC and MD Licensed Medical Director

    DC and MD Licensed Medical Director

    VirtualVocations • Baltimore, Maryland, United States
    Full-time
    A company is looking for a Lead Medical Director for Utilization Management.Key Responsibilities Oversee the execution of case management, disease management, and utilization review operations C...Show more
    Last updated: 1 day ago • Promoted
    Director of Clinical Transformation

    Director of Clinical Transformation

    VirtualVocations • Baltimore, Maryland, United States
    Full-time
    A company is looking for a Director of Clinical Transformation.Key Responsibilities Manage the development and deployment of clinical transformation programs to improve quality and patient servic...Show more
    Last updated: 30+ days ago • Promoted
    New Jersey Licensed Behavioral Medical Director

    New Jersey Licensed Behavioral Medical Director

    VirtualVocations • Baltimore, Maryland, United States
    Full-time
    A company is looking for a Behavioral Medical Director for the East Region, working remotely.Key Responsibilities Oversee and direct the Utilization Management Program, ensuring delivery of quali...Show more
    Last updated: 3 days ago • Promoted
    New York Licensed Behavioral Medical Director

    New York Licensed Behavioral Medical Director

    VirtualVocations • Baltimore, Maryland, United States
    Full-time
    A company is looking for a Behavioral Medical Director - Remote.Key Responsibilities Oversee and guide the Utilization Management team, ensuring cost-effective quality care Implement Level of Ca...Show more
    Last updated: 30+ days ago • Promoted
    Maryland Licensed Medical Director

    Maryland Licensed Medical Director

    VirtualVocations • Baltimore, Maryland, United States
    Full-time
    A company is looking for a Health Plan Medical Director Physician.Key Responsibilities Participate in the development and execution of case management, disease management, and population health m...Show more
    Last updated: 28 days ago • Promoted
    Director

    Director

    LifeBridge Health • Randallstown, MD, US
    Full-time
    Director, Patient Care Services - Nursing Ops And Behavioral Health.Full-time - Day shift - 7 : 30am-4 : 00pm.Directs and oversees all activities of the Patient Care Services division for Nursing Opera...Show more
    Last updated: 21 days ago • Promoted
    Director of Development

    Director of Development

    Shepherds Clinic Inc • Baltimore, MD, US
    Full-time +1
    Founded in 1991, Shepherds Clinic began as a grassroots effort in a Baltimore row house, staffed by volunteers, to respond to the overcrowding of the hospitals emergency room by non-emergency, unin...Show more
    Last updated: 30+ days ago • Promoted
    Regional Medical Director - Cardiology

    Regional Medical Director - Cardiology

    MedStar Health • Baltimore, MD, US
    Full-time
    MedStar Health is seeking a full-time, board certified, experienced cardiologist to serve as the Regional Medical Director for the echocardiography program in Baltimore. Last year, our experienced e...Show more
    Last updated: 2 days ago • Promoted
    Director of Advancement

    Director of Advancement

    Chesapeake Bay Outward Bound School • Gwynn Oak, MD, US
    Full-time
    The Director of Advancement is a senior leader responsible for driving CBOBS’s fundraising and communications strategy to support an annual philanthropic revenue goal of $2.M and positioning ...Show more
    Last updated: 25 days ago • Promoted
    Medical Director

    Medical Director

    VirtualVocations • Baltimore, Maryland, United States
    Full-time
    A company is looking for a Medical Director to oversee clinical documentation and coding compliance for inpatient charts. Key Responsibilities Provide clinical leadership and maintain collaborativ...Show more
    Last updated: 30+ days ago • Promoted