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Aetna Exec Dir, Aetna Commercial Compliance in Hartford, Connecticut

Req ID: 66168BR

Job Description

This position is a leadership role for the Company regarding compliance discussions with regulatory authorities. The incumbent will lead and direct a team of compliance professionals responsible for coordinating regulatory activity in U.S. states and territories. This team interacts with federal and state regulators regarding examinations activity and inquires as well as the implementation of laws and regulations. The incumbent will also manage individuals who support business areas working on Aetna Commercial Plans as they develop and deploy risk mitigation strategies and correct and prevent issues. The position collaborates with Aetna business leaders and colleagues to ensure business accountability to remediate issues and strengthen controls. In addition, the position will work closely with business leadership to ensure there is a good understanding of and commitment to ethical and compliance standards.

This role will report to the enterprise Vice President, Compliance Operations and will ideally be located in Hartford CT.

Fundamental Components included but are not limited to:

  • Advise Compliance leadership on legal and regulatory matters related to compliance with applicable laws, regulations and contract requirements based on interactions with Federal and State regulators, examining entities and business partners.

  • Partner with aligned business functions to ensure internal controls are implemented to effectively prevent, identify and resolve issues quickly and effectively.

  • Manage Senior Directors responsible for regulatory interaction including examinations and response to regulatory inquiries.

  • Manage individual contributor who develops certain Compliance reports, such as Aetna legal entity audit committee reports, state compliance dashboard, etc.

  • This role is a member of the Regulatory Review Board and participates in the Aetna legal entity audit committee meetings.

  • Provide leadership of process to monitor fulfillment of conditions related to States approval of CVS Health s acquisition of Aetna. Develop and distribute monthly status report to Enterprise Leaders.

  • Provide Internal Audit a view of regulatory risk areas in a regular cadence.

  • Lead a Commercial Business Compliance Office (BCO) team responsible for partnering with business units to implement the requirements of new laws, regulations and settlement agreements.

  • Partner with Legal and the Compliance Risk Administration team to perform periodic compliance risk assessments of Aetna Commercial, Institution and Specialty Product businesses

Qualifications Requirements and Preferences:

  • A minimum of 15+ years of relevant work experience in Health Insurance regulatory or operations, preferably at Aetna, i.e. health care laws, health insurance and related product operations, regulatory standards, and management of change and controls process.

  • Strong understanding of Federal and State regulatory environments and professional work experience with or for Federal and State agencies.

  • Proven success in a leadership role.

  • Strong knowledge of the life cycle of commercial health insurance and related products.

  • Proven ability to influence to other functional areas, leaders and external parties, as applicable, to ensure appropriate compliance solutions and controls are implemented; strong negotiation skills.

  • Executive presence and proven communications skills including ability to collaborate with and influences senior level executives/key decision makers; this position requires a high level of professionalism

Required Skills:

Leadership - Collaborating for Results, Leadership - Creating Accountability, Leadership - Driving a Culture of Compliance

Benefit Eligibility

Benefit eligibility may vary by position. Click here to review the benefits associated with this position.

Job Function: Legal

Aetna is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected Veterans status.