Lead, Florida Behavioral Health & Specialty Programs

CVS Health; Fort Lauderdale (FL); Sur place; USD 100 000 - 232 000; Plein temps

Résumé du poste

CVS Health in Florida seeks a Lead Director to shape and execute the behavioral health and specialty programs for Florida Medicaid and Florida Healthy Kids, focusing on children and adolescents with complex needs. The role reports to the Health Plan CEO and drives clinical and operational excellence.

You will partner with medical directors, network teams, and quality units to improve outcomes, manage risk, and ensure regulatory compliance, while leading cross‑functional implementation and

Qualifications

• 10+ years in Medicaid managed care or related field with at least 5 years in leadership.
• Experience serving vulnerable or complex populations in clinical or business roles.
• Strong knowledge of Florida Medicaid behavioral health and related services.
• Experience leading cross-functional program implementation and regulatory compliance.
• Ability to use data to set priorities and drive measurable results.
• Executive communication, stakeholder management and change leadership skills.
• Willingness to travel 20-30% as needed.
• Residence in Florida is required.

Responsabilités

• Lead development and implementation of BH & specialty programs for Florida Medicaid and Florida Healthy Kids.
• Coordinate care management, utilization management, pharmacy, LTSS, quality, claims, and provider networks.
• Use data to identify gaps and improve access, engagement, follow-up, and readmissions.
• Drive measurable BH outcomes improvements with Quality and VBC teams.
• Serve as SME and relationship leader for providers; enhance capacity and value-based arrangements.
• Oversee BH vendors and providers for clinical effectiveness and ROI.
• Monitor utilization, cost and trends; address fraud, waste and compliance concerns.
• Represent the plan with AHCA, DCF, ME entities and partners; support audits and reporting.

Connaissances

Medicaid managed care

Behavioral health operations

Population health

Leadership

Data-driven decisions

Executive communication

Stakeholder management

Change leadership

Travel 20-30%

Florida residence

Formation

Bachelor’s degree in behavioral health or related field

Description du poste

CVS Health in Florida seeks a Lead Director to shape and execute the behavioral health and specialty programs for Florida Medicaid and Florida Healthy Kids, focusing on children and adolescents with complex needs. The role reports to the Health Plan CEO and drives clinical and operational excellence.

You will partner with medical directors, network teams, and quality units to improve outcomes, manage risk, and ensure regulatory compliance, while leading cross‑functional implementation and