AVP, General Manager - Medicare - NY/NJ Market

CVS Health • York, PA

76d

About The Position

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. Position Summary 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 AVP, General Manager who has Medicare market specific P&L accountability for the IVL/DSNP products in their market, supporting Sales and customer experience agendas in market as well as Go-To Market planning and acquisition cost. This position is the leader for market performance, cost structure and local execution of medical costs management, compliance, and revenue integrity efforts for all Medicare Advantage products (inclusive of collaborating with the Employer Group team for EGWP products to achieve sales and client satisfaction goals) in collaboration with corporate teams. The Market GM will drive local product strategy and local market intelligence, be responsible for achieving target market position, market share growth, and drive cost structure reduction (SAIs) in collaboration with Medicare segment leadership, the market medical teams, Network Management teams and other related teams.

Requirements

• 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:
• 10+ years of relevant experience in line of business management.
• Deep knowledge of the Medicare business.
• Must have P&L expertise and possess a strong financial, bottom-line focus.
• Ability to deal effectively with multiple internal and external clients.
• Ability to effectively interact with a diverse workforce and cross functional groups.
• Strong facilitative leadership and business problem solving skills are required.
• Ability to deal effectively with multiple internal and external clients is required.
• Knowledge of insurance regulatory and contractual requirements.
• Knowledge of value based provider contracting.
• Knowledge of current health care marketplace dynamics and Aetna’s position in the market.
• Ability to effectively interact with a diverse workforce and cross functional groups required.
• Experience leading and developing people, preferably leading managers.
• Proven team leadership experience - leadership skills to build high-performing teams, manage and develop talent, influence, and impact a broad set of stakeholders, engage, and inspire others, and lead by example.
• Skilled at collaborating and working across a complex matrixed organization.
• Must live in the market (NY or NJ) or nearby states (CT or PA) only.

Responsibilities

• Responsibility for supporting Medicare programs with short-and-long term profitability and growth of the health plan.
• Spearheading the implementation of new contracts, programs, services, and preparation of bid and grant proposals.
• Responsibility for the overall financial performance and achievement of the budget of the Medicare plans within the Market.
• Direction of senior leaders of specific functional areas as assigned. Functional areas may include operations, sales, marketing, provider relations, network development, utilization management, and/or STARS/HEDIS quality improvement, and Revenue Integrity efforts.
• Coordinating and monitoring functional integration of these areas in cooperation with corporate departments to achieve planned business results.
• Leading all departments in the development, implementation and maintenance of policies and procedures to ensure compliance with the State and Federal regulatory requirements.
• Responsibility for the plan performance related to all required State and Federal audits.
• Responsibility for the management and organization of plan activities at the health plan as it relates to the Medicare business.
• Monitoring the budget in assigned functional areas and takes corrective actions when necessary.
• Leading and developing people, preferably leading managers.
• Proven team leadership experience - leadership skills to build high-performing teams, manage and develop talent, influence, and impact a broad set of stakeholders, engage, and inspire others, and lead by example.
• Ability to lead teams and drive performance in a dynamic and fast-paced environment.
• Partnering effectively within the team and across the organization to ensure strategic initiatives stay aligned to plan and elevate solutions to barriers and decisions needed to executive leaders at the highest levels of organization.
• Creating and executing a sustainable, and profitable-growth strategy.
• Accountability for working with Medicare segment functional areas for monthly results, bid execution and other MAO responsibilities.

Benefits

• 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.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 5,001-10,000 employees