VP, CEO of Aetna Better Health of Oklahoma
About The Position
Aetna Better Health is Aetna’s Medicaid managed care plan. Backed by over 30 years of experience managing the care of those with a broad array of health care needs, our Medicaid plans have demonstrated that getting the right help when you need it is essential to better health. That’s why Aetna® Medicaid plans include the guidance and support needed to connect our members with the right coverage, resources and care. We are focused on enhancing quality and population health outcomes while integrating CVS assets to bring accessible healthcare to our members. The Chief Executive Officer has the responsibility for growing and leading the Medicaid business in Oklahoma. This includes general administration and implementation of all contract requirements, including ownership of profit and loss: meeting revenue, maintaining, and growing membership, network adequacy, member and provider satisfaction and operating income plans.
Requirements
- 10+ years progressive management experience in managed care with demonstrated experience with P&L leadership.
- Knowledge and experience of Medicaid principles and strong State Regulator relationship management.
- Familiarity with the state of Oklahoma will be highly valued
- Experience with RFP bid responses and orals presentations will be highly valued.
- Experience with all aspects of successful plan management: Compliance and Regulatory Oversight, Member Experience, Provider Engagement Strategy, Member Advocacy/Outreach/Retention, Quality Management/Outcomes, Population Health/Heath Equity/ SDOH, Network Development and overall Operational Execution
- Value Based Contracting experience will be valued.
- Proven ability to work successfully within a matrix environment and influence internal stakeholders.
- Growth mindset and strong relationship management skills
- Strong people management skills and proven experience leading teams through growth and change.
- Strong relationship management skills – internal stakeholders and external.
- Proven ability to effect change, meet business goals, monitor progress, and take corrective actions when necessary.
- Proven ability to understand business strategies and formulate concise solutions to complex problems.
Responsibilities
- Establishes and maintains an efficient and innovative approach to reviewing/assessing the State contract, providing consistent contract reporting, and suggesting actions to improve services to the State agency.
- Communicates state agency requirements for program implementations; coordinates with internal resources to implement contract requirements; communicates ongoing implementation progress with representatives of the State and regulatory agencies
- Achieves and maintains full understanding of the contract/requirements, programs, and policies, including service scope, special service features, history of service issues, and contact with State representatives.
- Creates and maintains a macro-environmental view of the competitive landscape, regulatory and legislative impact to the plan.
- Develops and maintains safety net provider relations, provider services, community involvement and promotes awareness of the plan.
- Strategic planning and development of the operating plan to support business operations.
- Builds commitment and support of matrix partners to achieve shared business goals.
- Works with management teams locally and across shared business partners to develop quality improvement plans and cost savings initiatives.
- Motivates and leads a high-performance management team, with a focus on recruiting, training, developing, and retaining experienced staff.
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.
- medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.
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What This Job Offers
Job Type
Full-time
Career Level
Executive
Education Level
No Education Listed
