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Aetna VP, CEO Medicaid - Florida in Plantation, Florida

Req ID: 64095BR

Job Description

This full-time position is the top executive position for Aetna Better Health of FL Medicaid Plan and is the lead contact for all communication between the State Medicaid Department, Agency for Health Care Administration (AHCA) and FL Healthy Kids. The Chief Executive Officer (CEO) has accountability and authority for administration and implementation of all contract requirements, including ownership of profit and loss: meeting revenue, membership and operating income plans. The CEO is responsible for the daily conduct, compliance and operations of the FL Managed Care Medicaid, Long Term Care and Florida Healthy Kids plans. The primary office location is Plantation FL, other offices are located in Doral, Tampa, Tallahassee, Orlando, and Boynton Beach. Travel to all offices is expected, as well as travel to meet and engage with key stakeholders including, but not limited to Hospitals, Providers and FQHCs within the state of FL. There will be some minimal travel required outside of FL, to the corporate offices in Phoenix Arizona and other East Region locations for Management Meetings.

Fundamental Components included but are not limited to:

Establishes and maintains an effective management process and system for reviewing/assessing the State contract, for Compliance, Reporting and achieving State goals and objectives. CEO will insure the State relationship is a trusting, effective relationship, offering support and actions to improve services to the State agency. Will be 100 percent assigned to the contract, with overall responsibility for the administration of the contract and daily operations, including overseeing the budget and accounting system. 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. Assists representatives of the State agency, as requested, regarding issues related to all administrative services. 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. Implements contract requirements. Responsible for successful implementation of all of the contractual requirements, Value Based contracting goals, Quality and Member outcomes. Oversees the day-to-day operations of the staff in achieving goals set forth to meet State goals and objectives. Some staff are direct while others are dotted line. Must be able to manage in a matrix environment with Shared Services partners. Manages operations, meets/exceed goals within the approved budget. Participates and engages in all State level meetings, this role is the face of the Managed Care Organization Plan and develops and oversees all State, Community and Provider relationships, including all Value Based Contracting relationships. 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. Works with management team to develop quality improvement and cost savings initiatives. Motivates and leads a high-performance management team, recruiting, training, developing mentoring and retaining experienced staff. .

Qualifications Requirements and Preferences:

Minimum of 10 years progressive management experience in managed care or a health care related position, with demonstrated experience and results in financial management, operations, medical delivery and/or managed care systems. Effective technical skills regarding health plan administration, medical management cost drivers/trends, actuarial and underwriting.

Technology Experience:

Desktop Tool - Microsoft PowerPoint, Desktop Tool - Microsoft SharePoint, Desktop Tool - Microsoft Word, Desktop Tool - TE Microsoft Excel

Additional Job Information:

Bachelor's degree or equivalent experience, Master's degree preferred. - Effective and advanced oral and written communication skills required; must have senior level experience with Medicaid programs and regulations, a professional image, and the ability to interface with State and community leaders. - Ability to manage projects and project time constraints. - Ability to lead and influence, motivate and educate staff. - Minimum of seven years of recent and related progressive leadership experience in the healthcare industry. - Ability to represent organization and company in external meetings and or healthcare venues. - Ability to work on multiple projects with tight deadlines - Effective organizational skills and ability to manage multiple tasks. - Proficiency with Microsoft Office Suite applications. Are you ready to join a company that is changing the face of health care across the nation? Aetna Better Health of FL is looking for people like you who value excellence, integrity, caring and innovation. As an employee, you ll join a team dedicated to improving the lives of the most vulnerable in our population. Our vision incorporates community-based health care that works. We value diversity. Align your career goals with Aetna Better Health of FL, and we will support you all the way.

Closing Statement

At CVS/Aetna, we share a single, clear purpose: helping members on their path to better health. You ll be part of a team working toward a bold new approach to health care. We are transforming the consumer health experience by connecting with people in their communities. We engage consumers with the care they need, when and where they need it. We take an integrated holistic approach for consumer care. Beyond our vast multidisciplinary physical and behavioral networks, our members can access information about their health care needs at our CVS stores or through the CVS Health Hubs and Minute Clinics.

We care about each other, our customers and our communities. We are inspired to make a difference, and we are committed to integrity and excellence.

Together we will empower people to live healthier lives.

CVS/Aetna is an equal opportunity & affirmative action employer. All qualified applicants will receive consideration for employment regardless of personal characteristics or status. We take affirmative action to recruit, select and develop women, people of color, veterans and individuals with disabilities.

We are a company built on excellence. We have a culture that values growth, achievement and diversity and a workplace where your voice can be heard.

Benefit Eligibility

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

Job Function: Management

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.

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