Job Description

Job Description
Market level senior leadership role responsible for ensuring that local provider network performance results meet the cost, adequacy, and compliance goals of the company. This includes oversight of the provider contracting and approval process, accountability for the most complex and challenging contractual relationships with providers, and working cross-functionally within the markets and nationally to ensure consistency with all contracting strategies. Maintains overall accountability for medical cost management within the local market geography.

Required Qualifications
- Responsible for network and operational infrastructure in the local market aligned to cost related levers and ensuring the market network(s) meet cost metrics, adequacy standards, network compliance regulations, and profitability goals.
- Responsible for setting local market network strategy and budget for market contracting across all provider types and product segments, leading innovation across traditional and non-traditional models for all lines of business, coordinating expansion activities, and driving towards local market and national goals.
- Manages all local market provider relations and directs implementation and operations of Value Based Contracting arrangements.
- Continually evaluates Market bottom line, manages medical costs in close partnership with Clinical Functions and drives change to improve cost structure partnership.
- Ownership of local market specific MER, P-model, SAI, VBC strategy, and unit cost management.
- Represents Aetna to the legislative, regulatory and community partners, improves public relations, and manages regional public policy issues.
- Coaches, mentors, and manages performance of team members; drives talent development and actively builds bench for key roles.
- Establishes collaborative relationships with local market leaders, National Network, Product, Clinical, Finance, Marketing, Actuarial, and Medical Economics Unit across Commercial and Medicare segments to achieve company and market objectives.
- Leads continuous organizational improvement to drive VBC competency and enhance provider experience.

Preferred Qualifications
- Expertise in market level management, cost drivers and levers, and knowledge of economic, regulatory and marketplace issues.
- Expertise in creating and leading Accountable Care and Population Health Management organizations.
- Advanced network capability, understanding of reimbursement methodologies and experience negotiating and interacting with large physician groups and hospital systems.
- Ability to clearly identify, articulate and execute on business strategies to reach market objectives.
- Ability to link strategic planning objectives to operational execution.- Excellent analytical, organizational, management, writing and communication skills in a highly matrixed environment.
- Strong interpersonal skills with ability to work cooperatively to achieve overall organizational goals.
- Executive presence

Education
Bachelor's degree or equivalent experience

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.