Job Details
AVP, Chief Network Officer: Mid-South
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.
**The Chief Network Officer for Aetna is accountable for strategic and operational leadership, the development and implementation of network strategies and for cultivating positive relationships with local market providers. 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** **Mid South Territory (North Carolina, South Carolina, Tennessee, Alabama, Mississippi)** **and report to the VP, Regional Leader - Southeast**
**Key Responsibilities:**
**Lead the local Network teams accountable for implementing the Network strategy with a focus on optimizing network performance and delivering competitive costs in alignment with strategic objectives.**
**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 adherence to core operational processes for contract administration, 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 network strategy for fee for service contracting and 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 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 to support state network filings and other compliance deliverables**
**Active engagement in the development and assessment of internal policies impacting Providers and Network?**
**Location: Must live within region with preference for North Carolina or Tennessee.**
**Qualifications:** **?**
**12+ 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 all provider types**
**Knowledge of Commercial, IFP, Medicare, Medicaid lines of business**
**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 record of accomplishment of delivering results.**
**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 our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:
+ **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.
For more information, visit https://jobs.cvshealth.com/us/en/benefits
We anticipate the application window for this opening will close on: 05/02/2025
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.
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.
**The Chief Network Officer for Aetna is accountable for strategic and operational leadership, the development and implementation of network strategies and for cultivating positive relationships with local market providers. 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** **Mid South Territory (North Carolina, South Carolina, Tennessee, Alabama, Mississippi)** **and report to the VP, Regional Leader - Southeast**
**Key Responsibilities:**
**Lead the local Network teams accountable for implementing the Network strategy with a focus on optimizing network performance and delivering competitive costs in alignment with strategic objectives.**
**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 adherence to core operational processes for contract administration, 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 network strategy for fee for service contracting and 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 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 to support state network filings and other compliance deliverables**
**Active engagement in the development and assessment of internal policies impacting Providers and Network?**
**Location: Must live within region with preference for North Carolina or Tennessee.**
**Qualifications:** **?**
**12+ 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 all provider types**
**Knowledge of Commercial, IFP, Medicare, Medicaid lines of business**
**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 record of accomplishment of delivering results.**
**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 our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:
+ **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.
For more information, visit https://jobs.cvshealth.com/us/en/benefits
We anticipate the application window for this opening will close on: 05/02/2025
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.
Job #NLX274961447