Lead Director - Aetna Interoperability Governance...

Leads enterprise data governance, privacy, and risk management efforts to ensure the compliant, secure, and responsible use of data across all lines of business, including Commercial, Medicare, and Medicaid. This role establishes and operationalizes governance frameworks, decision protocols, standards, and controls that promote data quality, transparency, accountability, and appropriate use of sensitive health information. The position partners closely with Legal, Compliance, Security, Informatics, and business leaders to translate regulatory requirements, contractual obligations, and enterprise policies into practical governance processes and risk-based controls. The role is responsible for identifying, assessing, and mitigating risks across data sharing, access, lineage, downstream use, and third-party relationships, while enabling audit-defensible decision-making and scalable governance practices aligned with business objectives and regulatory expectations, including HIPAA, CMS mandates, and state privacy requirements. The incumbent is additionally expected to lead communication strategy across varied audiences and organizational levels, and to drive outcomes through highly polished, structured program management disciplines.

• 10+ years of experience in healthcare, data governance, privacy, risk management, or a related field

• Deep knowledge of healthcare regulations, including HIPAA, CMS requirements, and state privacy laws

• Experience with data governance frameworks, data lineage, metadata management, and stewardship practices

• Strong understanding of payer operations, including claims, utilization management, risk adjustment, and STARS

• Expertise in risk identification, assessment, mitigation planning, control design, and reporting

• Ability to translate legal and regulatory requirements into operational and technical processes

• Strong stakeholder management, executive communication, and cross-functional collaboration skills

• Ability to influence leaders and drive alignment across functions and throughout the enterprise

• Experience defining and operationalizing risk mitigation strategies and governance solutions

• Demonstrated ability to develop and execute audience-specific communication strategies across operational, management, and executive levels of an organization

• Proven experience crafting polished executive briefings, board materials, and governance communications that make complex topics accessible and decision-ready

• Strong program management skills, including experience driving structured programs with defined milestones, RACI accountability, risk management, and executive-level status reporting

Preferred Qualifications

• Degree in legal studies, privacy engineering, information technology, communications, or a related discipline

• Familiarity with AI governance, bias oversight, or emerging technology risk management

• Understanding of clinical data, EMRs, HIEs, and health information exchange practices

• Privacy certifications such as CIPM or CIPP

• Risk management certifications such as CRISC, PMI-RMP, or COSO ERM familiarity

• Familiarity with enterprise or solution architecture concepts

• Lean Six Sigma or other process improvement experience

• Experience supporting governance committees, decision forums, or enterprise control processes

• Familiarity with data governance tools, data catalogs, metadata platforms, or control documentation repositories

• Experience preparing documentation, evidence, or responses for audits, compliance reviews, or regulatory inquiries

• Experience assessing third-party data sharing arrangements, contractual controls, and downstream data use considerations

• Experience with issue management, remediation planning, and control monitoring in a regulated environment

• PMP, PgMP, or equivalent program management certification

• Experience developing and managing program governance frameworks across large, matrixed organizations

• Background in executive communications, change management, or organizational communications strategy, Bachelor’s degree preferred/specialized training/relevant professional qualification. lease replace this section with the Education Requirements

$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. 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.

This full-time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well-being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.