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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.
"candidate may reside anywhere in the US"
**Position Summary**
Join the Aetna Quality Management team in a key leadership role overseeing strategy and implementation of HEDIS and Medicare Stars measures. This position sits within the Aetna Clinical Services organization and supports quality performance across Medicare and Duals lines of business. Reporting to the Lead Director of Healthcare Quality Management, the Senior Manager will lead a team responsible for measure strategy, roadmap oversight, and execution of initiatives that drive performance improvement. This role requires deep expertise in HEDIS and Medicare Stars, strong project leadership, and the ability to influence cross-functional teams to achieve enterprise quality goals.
**Key Responsibilities**
· Lead a team focused on HEDIS and Medicare Stars strategy and execution.
· Develop and maintain the master roadmap for HEDIS and Stars measures, ensuring alignment with enterprise goals and regulatory timelines.
· Provide strategic direction for HEDIS and Medicare Stars performance improvement, including gap closure initiatives, member engagement strategies, and provider collaboration.
· Mentor team members on quality management interventions, strategic planning, and performance analytics.
· Collaborate with internal departments (e.g., Clinical Operations, Data Analytics, Regulatory Affairs) to analyze data and lead data-driven initiatives that improve member outcomes and Stars ratings.
· Ensure implementation and monitoring of internal and external programs designed to impact member experience, clinical quality, and access measures.
· Drive operational efficiency and build scalable capabilities to support Stars and HEDIS performance.
· Prepare and deliver presentations for executive stakeholders, translating complex data and strategy into actionable insights.
· Foster a culture of teamwork, innovation, and accountability across the team and broader organization.
**Required Qualifications**
· 7-10 years of relevant work experience required
· 2+ years of people management experience with multiple direct reports.
· Demonstrated success managing programs in a matrixed environment.
· Strong understanding of HEDIS and Medicare Stars measures, methodologies, and regulatory requirements.
· Exceptional interpersonal and stakeholder management skills.
· Advanced problem-solving and critical thinking abilities.
· Excellent communication skills, including experience preparing executive-level documents and presentations.
· Expertise in PowerPoint and Excel.
· Proven ability to adapt to change and align with evolving priorities.
**Preferred Qualifications**
· PMP (Project Management Professional) certification or equivalent.
· Experience with CMS Stars strategy, NCQA reporting, or value-based care initiatives.
· Familiarity with data visualization tools (e.g., Power BI, Tableau) and SQL.
· CPHQ (Certified Professional Healthcare Quality) certification or equivalent
**Education**
Bachelor's Degree, Master's Degree in Public Health, Health Administration, or related field preferred.
**Pay Range**
The typical pay range for this role is:
$67,900.00 - $199,144.00
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.
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We anticipate the application window for this opening will close on: 11/18/2025
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.