Deep expertise in integrated Medicare-Medicaid products, including DSNP/FIDE models. * Strong knowledge of health plan operations, medical management, quality and STARs performance, provider networks ...
Deep expertise in integrated Medicare-Medicaid products, including DSNP/FIDE models. * Strong knowledge of health plan operations, medical management, quality and STARs performance, provider networks ...
Nurse Navigator, DSNP
Wheeling, WV · On-site
The D-SNP (Dual-Eligible Special Needs Plan) Nurse Navigator is responsible for the navigation and advocacy of members who are dually eligible for both Medicare and Medicaid. These members often have ...
Quick apply
Nurse Navigator, DSNP
Wheeling, WV · On-site
The D-SNP (Dual-Eligible Special Needs Plan) Nurse Navigator is responsible for the navigation and advocacy of members who are dually eligible for both Medicare and Medicaid. These members often have ...
Risk Adjustment Director
Scotts Valley, CA · On-site +1
Current DSNP membership is approximately 800, with projected growth to 2,000 by year-end. While this is a leadership position, the current stage of the program requires a hands-on approach. The ...
Risk Adjustment Director
Scotts Valley, CA · On-site +1
Current DSNP membership is approximately 800, with projected growth to 2,000 by year-end. While this is a leadership position, the current stage of the program requires a hands-on approach. The ...
Health Services Officer
Santa Barbara, CA · On-site
$288K - $461K/yr
Leading the Health Services Division, which encompasses Utilization Management, Case Management, DSNP Clinical Operations, Whole Child Model, Behavioral Health, and Pharmacy. * Overseeing the ...
Health Services Officer
Santa Barbara, CA · On-site
$288K - $461K/yr
Leading the Health Services Division, which encompasses Utilization Management, Case Management, DSNP Clinical Operations, Whole Child Model, Behavioral Health, and Pharmacy. * Overseeing the ...
Claim Examiner I
Miami, FL · On-site
Review, analyze, and process medical claims in accordance with Medicare and DSNP benefit structures, policies, and procedures. * Accurately adjudicate new day claims, ensuring proper application of ...
New
Claim Examiner I
Miami, FL · On-site
Review, analyze, and process medical claims in accordance with Medicare and DSNP benefit structures, policies, and procedures. * Accurately adjudicate new day claims, ensuring proper application of ...
New
Risk Adjustment Director
Merced, CA · On-site +1
Current DSNP membership is approximately 800, with projected growth to 2,000 by year-end. While this is a leadership position, the current stage of the program requires a hands-on approach. The ...
Risk Adjustment Director
Merced, CA · On-site +1
Current DSNP membership is approximately 800, with projected growth to 2,000 by year-end. While this is a leadership position, the current stage of the program requires a hands-on approach. The ...
Risk Adjustment Director
Santa Cruz, CA · On-site +1
Current DSNP membership is approximately 800, with projected growth to 2,000 by year-end. While this is a leadership position, the current stage of the program requires a hands-on approach. The ...
Risk Adjustment Director
Santa Cruz, CA · On-site +1
Current DSNP membership is approximately 800, with projected growth to 2,000 by year-end. While this is a leadership position, the current stage of the program requires a hands-on approach. The ...
Risk Adjustment Director
Merced, CA · On-site +1
Current DSNP membership is approximately 800, with projected growth to 2,000 by year-end. While this is a leadership position, the current stage of the program requires a hands-on approach. The ...
Risk Adjustment Director
Merced, CA · On-site +1
Current DSNP membership is approximately 800, with projected growth to 2,000 by year-end. While this is a leadership position, the current stage of the program requires a hands-on approach. The ...
Risk Adjustment Director
Mariposa, CA · On-site +1
Current DSNP membership is approximately 800, with projected growth to 2,000 by year-end. While this is a leadership position, the current stage of the program requires a hands-on approach. The ...
Risk Adjustment Director
Mariposa, CA · On-site +1
Current DSNP membership is approximately 800, with projected growth to 2,000 by year-end. While this is a leadership position, the current stage of the program requires a hands-on approach. The ...
Claim Examiner I
Miami, FL · On-site
$19 - $23/hr
Review, analyze, and process medical claims in accordance with Medicare and DSNP benefit structures, policies, and procedures. * Accurately adjudicate new day claims , ensuring proper application of ...
Quick apply
Claim Examiner I
Miami, FL · On-site
$19 - $23/hr
Review, analyze, and process medical claims in accordance with Medicare and DSNP benefit structures, policies, and procedures. * Accurately adjudicate new day claims , ensuring proper application of ...
Risk Adjustment Director
Salinas, CA · On-site +1
Current DSNP membership is approximately 800, with projected growth to 2,000 by year-end. While this is a leadership position, the current stage of the program requires a hands-on approach. The ...
Risk Adjustment Director
Salinas, CA · On-site +1
Current DSNP membership is approximately 800, with projected growth to 2,000 by year-end. While this is a leadership position, the current stage of the program requires a hands-on approach. The ...
Risk Adjustment Director
Salinas, CA · On-site +1
Current DSNP membership is approximately 800, with projected growth to 2,000 by year-end. While this is a leadership position, the current stage of the program requires a hands-on approach. The ...
Risk Adjustment Director
Salinas, CA · On-site +1
Current DSNP membership is approximately 800, with projected growth to 2,000 by year-end. While this is a leadership position, the current stage of the program requires a hands-on approach. The ...
Risk Adjustment Director
Hollister, CA · On-site +1
Current DSNP membership is approximately 800, with projected growth to 2,000 by year-end. While this is a leadership position, the current stage of the program requires a hands-on approach. The ...
Risk Adjustment Director
Hollister, CA · On-site +1
Current DSNP membership is approximately 800, with projected growth to 2,000 by year-end. While this is a leadership position, the current stage of the program requires a hands-on approach. The ...
Risk Adjustment Director
Hollister, CA · On-site +1
Current DSNP membership is approximately 800, with projected growth to 2,000 by year-end. While this is a leadership position, the current stage of the program requires a hands-on approach. The ...
Risk Adjustment Director
Hollister, CA · On-site +1
Current DSNP membership is approximately 800, with projected growth to 2,000 by year-end. While this is a leadership position, the current stage of the program requires a hands-on approach. The ...
Risk Adjustment Director
Santa Cruz, CA · On-site +1
Current DSNP membership is approximately 800, with projected growth to 2,000 by year-end. While this is a leadership position, the current stage of the program requires a hands-on approach. The ...
Risk Adjustment Director
Santa Cruz, CA · On-site +1
Current DSNP membership is approximately 800, with projected growth to 2,000 by year-end. While this is a leadership position, the current stage of the program requires a hands-on approach. The ...
Risk Adjustment Director
Scotts Valley, CA · On-site +1
Current DSNP membership is approximately 800, with projected growth to 2,000 by year-end. While this is a leadership position, the current stage of the program requires a hands-on approach. The ...
Risk Adjustment Director
Scotts Valley, CA · On-site +1
Current DSNP membership is approximately 800, with projected growth to 2,000 by year-end. While this is a leadership position, the current stage of the program requires a hands-on approach. The ...
Educates members on the availability of DSNP if appropriate. * Documents accurately and comprehensively based on the standards of practice and current organization policies. * Interacts and ...
Educates members on the availability of DSNP if appropriate. * Documents accurately and comprehensively based on the standards of practice and current organization policies. * Interacts and ...
Risk Adjustment Director
Mariposa, CA · On-site +1
Current DSNP membership is approximately 800, with projected growth to 2,000 by year-end. While this is a leadership position, the current stage of the program requires a hands-on approach. The ...
Risk Adjustment Director
Mariposa, CA · On-site +1
Current DSNP membership is approximately 800, with projected growth to 2,000 by year-end. While this is a leadership position, the current stage of the program requires a hands-on approach. The ...
Health Services Officer
Santa Barbara, CA · On-site
$288K - $461K/yr
Leading the Health Services Division, which encompasses Utilization Management, Case Management, DSNP Clinical Operations, Whole Child Model, Behavioral Health, and Pharmacy. * Overseeing the ...
Health Services Officer
Santa Barbara, CA · On-site
$288K - $461K/yr
Leading the Health Services Division, which encompasses Utilization Management, Case Management, DSNP Clinical Operations, Whole Child Model, Behavioral Health, and Pharmacy. * Overseeing the ...
Educates members on the availability of DSNP if appropriate. * Documents accurately and comprehensively based on the standards of practice and current organization policies. * Interacts and ...
Educates members on the availability of DSNP if appropriate. * Documents accurately and comprehensively based on the standards of practice and current organization policies. * Interacts and ...
Dsnp information
See salary details
$39.5K - $42.8K
11% of jobs
$44.4K is the 25th percentile. Wages below this are outliers.
$42.8K - $46K
29% of jobs
The median wage is $48.4K / yr.
$46K - $49.3K
14% of jobs
$49.3K - $52.6K
0% of jobs
$52.6K - $55.9K
0% of jobs
$55.9K - $59.1K
3% of jobs
$59.1K - $62.4K
15% of jobs
$62.4K - $65.7K
2% of jobs
$66.1K is the 75th percentile. Wages above this are outliers.
$65.7K - $69K
9% of jobs
$69K - $72.2K
7% of jobs
$72.2K - $75.5K
9% of jobs
$39.5K
$56K
$75.5K
How much do dsnp jobs pay per year?
What is the difference between Dsnp vs Medicaid Specialist?
| Aspect | Dsnp | Medicaid Specialist |
|---|---|---|
| Required Credentials | High school diploma or equivalent; some roles may require certifications | High school diploma; certifications in Medicaid programs often preferred |
| Work Environment | Healthcare settings, community outreach, insurance companies | Healthcare facilities, insurance agencies, government offices |
| Employer & Industry Usage | Insurance companies, healthcare providers, government programs | State Medicaid agencies, healthcare organizations, insurance firms |
Dsnp (Dual Special Needs Plan) coordinators focus on managing specific Medicare and Medicaid plans for eligible beneficiaries, while Medicaid Specialists handle Medicaid program enrollment, compliance, and client support. Both roles require knowledge of Medicaid policies, but Dsnp roles are more specialized within Medicare-Medicaid integration, whereas Medicaid Specialists have broader Medicaid program responsibilities.

$131K - $303K/yr
Full-time
Medical, Dental, Vision, Retirement, PTO
Posted 27 days ago
CVS Health rating
5.8
Based on 4,230 frontline employees who took The Breakroom Quiz
79th of 99 rated pharmacies
Job description
We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselvesaccountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time.
Role Overview
At Aetna, our health benefits business, we are committed to helping our members achieve their best health in an affordable, convenient, and comprehensive manner. Combining the assets of our health insurance products and services with CVS Health's unrivaled presence in local communities and their pharmacy benefits management capabilities, we're joining members on their path to better health and transforming the health care landscape in new and exciting ways every day.
Aetna is recruiting for an Executive Director who serves as a senior market executive with full accountability for the strategy, performance, and growth of Aetna's Integrated Dual Eligible Special Needs Plans across the Northeast Territory. This role leads one of Aetna's most strategically important markets and is responsible for financial outcomes, regulatory partnerships, and market execution for fully integrated Medicare-Medicaid products.
As the primary executive liaison to state agencies and external stakeholders, the Executive Director builds durable, trustbased relationships while driving profitable growth, regulatory compliance, and measurable improvement in member and provider experience.
Key Responsibilities
Market & P&L Leadership: Full ownership of financial performance, including budget attainment, margin improvement, and sustainable membership growth through disciplined revenue optimization, medical cost management, and administrative efficiency.
Strategic Execution: Set and execute market strategy to improve competitive position, quality outcomes (STARs), network performance, and operational effectiveness.
Regulatory & Government Relations: Serve as the senior executive relationship owner with state Medicaid agencies and regulators; represent plan interests with state officials, legislators, and industry associations.
Compliance & Risk Management: Ensure full compliance with all federal and state requirements; oversee audit readiness and accountability for regulatory performance.
Product & Growth Strategy: Lead local product design, bid development, and market intelligence efforts to support profitable growth, including oversight of supplemental benefits and delegated vendor partnerships.
Provider & Community Engagement: Strengthen provider, community, and stakeholder relationships to enhance member experience and provider satisfaction.
Enterprise Collaboration: Partner with Medicare, Medicaid, Duals segment leadership, and crossfunctional teams (network, clinical, quality, sales, marketing, operations) to deliver integrated results.
Talent & Leadership: Build and develop a highperforming leadership team; set clear performance expectations and invest in successor and talent development.
Contract & Program Implementation: Lead readiness and execution for new contracts, programs, and expanded services.
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:
15+ years of progressive leadership experience in managed care or healthcare, including direct responsibility for financial management.
Demonstrated P&L ownership with a strong financial and results orientation.
Deep expertise in integrated Medicare-Medicaid products, including DSNP/FIDE models.
Strong knowledge of health plan operations, medical management, quality and STARs performance, provider networks, NCQA accreditation, and regulatory compliance.
Proven ability to influence and lead within a complex, matrixed organization.
Skilled in leading, influencing, and motivating teams to achieve high performance and outcomes.
Strong executive presence, stakeholder management, and problem-solving skills.
Willingness to travel within the Northeast Territory as required.
Preferred Qualifications
Experience managing relationships with state Medicaid regulators and government stakeholders.
Existing relationships within New Jersey, New York, and/or Virginia highly valued.
Prior engagement with community organizations serving dualeligible populations.
Education
Bachelor's degree or equivalent work experience required (advanced degree 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 offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.
Additional details about available benefits are provided during the application process and on Benefits Moments.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
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About CVS Health
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Industry
Health care and social assistance and retail
Company size
10,000+ Employees
Headquarters location
Woonsocket, RI, US