Job Description

Job Description
Aetna, a CVS Health company is seeking to hire a Chief Executive Officer for its California Medicaid business. The Chief Executive Officer (CEO) has the responsibility for growing and maintaining the Medicaid business in California. 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.
Major
Responsibilities
Establishes and maintains an efficient innovative approach to for 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.
Responsible for managing the budget
Creates a macro-environmental view of competitive landscape, regulatory and legislative impact to the plan.
Develops safety net provider relations, provider services, community involvement and promotes awareness of the plan.
Strategic planning and development of operating plan to support business operations.
Builds commitment and support of matrix partners to achieve shared business goals.
Works with management team to develop quality improvement and cost savings initiatives.
Motivates and leads a high-performance management team, with a focus on recruiting, training, developing and retaining experienced staff.

Required Qualifications
See below

Preferred Qualifications
Minimum of 10 years progressive management experience in managed care or a health care related position, with demonstrated experience with all aspects of business development and financial management within a medical delivery and/or managed care systems.
Experience managing a P&L; with a focus on IPA, contracting and network.
o Knowledge of MediCAl will be valued
o Knowledge of provider dynamics (IPAs) required
Experience working with state regulators
Growth mindset and strong relationship management skills
Effective technical skills regarding health plan administration, medical management concepts and underwriting
Strong people management skills and proven experience leading teams thru growth and change.
Strong relationship management skills internal stakeholders and external
Strong analytical and critical thinking skills. Focus on driving disciplined, fact-based decisions, and executing with discipline and urgency.
Proven ability to effect change, meet business goals, monitor progress, and take corrective actions when necessary.
Align with the values of CVS Health Innovation, Collaboration, Caring, Integrity, Accountability.
Comprehensive knowledge of delivery system operations, provider contracting, strategic planning, and overall service delivery.
Strong financial management and negotiation skills.
Proven ability to understand business strategies and formulate concise solutions to complex problems

Education
to populate

Business Overview
At Aetna, a CVS Health company, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.

We are committed to maintaining a diverse and inclusive workplace. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, gender, gender identity, age, disability or protected veteran status. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.