AVP, Chief Network Officer - Heartland - Aetna
- Salary
- $157.8K–$363.9K
- Hiring from
- United States
- Work type
- Hybrid
- Posted
514,029 remote jobs, straight from company career pages
100% free · New jobs every hour
Show job descriptionHide 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 ourselves accountable 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.
AVP, Aetna - Chief Network Officer – Heartland
The Chief Network Officer for Aetna is responsible for the strategic and operational leadership and development along with implementation of network strategies and provider relations. Success will be measured by the executive’s ability to meet the organization’s growth, affordability, product, and the local market needs. This market leader will be responsible for the Heartland market (CO, ND, SD, NE, KS, IA, MO and Southern IL) and report to the VP, Regional Leader – Central .
Key Responsibilities:
Led the team that is accountable for leading and implementing the Network strategy focused on optimizing local market network performance and cost, delivering strategic network goals. Ensure all contracting efforts with hospital/provider systems deliver appropriate outcomes
Direct oversight of the provider network and responsible for managing the total cost of care for members and clients.
Ownership of local market specific unit cost targets, medical cost strategies, negotiation and administration of VBC contracts, risk adjustment and contract deviation
Accountable for lowest cost contracting efforts across all provider types. Ensure alignment to core processes for contract administration for example, accurate and timely contract loads.
Provide strategy and collaborate with medical management, medical policy development, pharmacy management, quality improvement, population health, provider network development, provider contracting and management, accreditation, and management of clinical delivery assets.
Cultivating strategies to improve the health care experience for members and for improving the experience of providers.
Thought leader that fosters deep collaboration with providers to facilitate joint design of innovative health improvement, member engagement, care management, and other initiatives that result in exceptional value and quality outcomes.
Oversee and ensure effective development and management of the provider network functions including provider development, provider relations, reimbursement, payment innovation, health care value transformation and network administration. Setting market network strategy for fee for service contracting as well as value-based care/population health.
Responsible for network and operational infrastructure aligned to cost related levers and ensuring the market network(s) meet cost metrics, adequacy standards, network compliance regulations, and profitability goals.
Sets the unit cost budget for contracting across all provider types and product segments, driving innovation across traditional and non-traditional models for all lines of business, coordinating expansion activities, and driving towards local market and national goals.
Manages their local market provider relations and directs implementation and operations of Value Based Contracting arrangements.
Manage medical costs in close partnership with Clinical Functions and drives change to improve cost structure partnership.
Develop and maintain strong relationships with the Market President, Market CFO, Medicare GM and Segment Leads in order to ensure alignment in developing and effecting strategies that drive profitable membership growth.
Partner with sales to develop and execute customer specific network solutions to retain and win critical plan sponsors.
Represent Aetna to the legislative, regulatory and community partners
Consult with the Market Compliance Consultant on state network filings and assign a network lead to support the filing
Active engagement in the development and assessment of internal policies impacting Providers and Network
Qualifications:
· A minimum of 15 years of healthcare network & contracting experience.
Medical Economics experience will be valued
· Proven people leadership skills
· Strong understanding of fee for service and value based contracting with hospital systems.
· Knowledge of Commercial, Medicare, Medicaid and Behavioral Health
· Strong presentation and communication skills; ability to consult as well as negotiate
· Strong analytical skills including root cause analysis
· Ability to think strategically
· Skilled at collaborating and working across a complex matrixed organization
· Expertise in market level management, cost drivers and levers, and knowledge of economic, regulatory and marketplace issues
· Possess exceptional leadership skills and transformational experience with a proven track record of delivering results.
· Must reside in the Heartland geography (CO, ND, SD, NE, KS, IA, MO and Illinois)
Pay Range
The typical pay range for this role is:
$157,800.00 - $363,936.00
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.
About us
Our Work Experience is the combination of everything that's unique about us: our culture, our core values, our company meetings, our commitment to sustainability, our recognition programs, but most importantly, it's our people. Our employees are self-disciplined, hard working, curious, trustworthy, humble, and truthful. They make choices according to what is best for the team, they live for opportunities to collaborate and make a difference, and they make us the #1 Top Workplace in the area.