CVS Health
AVP, Chief Network Officer - Florida & Georgia
CVS Health, Tampa, Florida, us, 33646
Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as what we deliver.
Our Heart At Work Behaviors support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.Position Summary:At Aetna, our health benefits business, we are committed to helping our members achieve their best health in an affordable, convenient, and comprehensive manner. Combining the assets of our health insurance products and services with CVS Health’s unrivaled presence in local communities and their pharmacy benefits management capabilities, we’re joining members on their path to better health and transforming the health care landscape in new and exciting ways every day.Aetna is recruiting for a Chief Network Officer who is responsible for local market strategic and operational leadership, development, and medical expense performance along with implementation of network strategies and provider relations. Success will be measured by the executive’s ability to meet the organization’s growth, profitability, affordability, product, and local market needs across all segments. This market leader will be responsible for the Florida and Georgia markets and report to the VP, Regional Network Leader.You’ll make an impact by:Leading the team that is accountable for leading and implementing Network strategy focused on optimizing local market network performance and cost, delivering strategic network goals. Ensuring all contracting efforts with hospital/provider systems deliver appropriate outcomes.Directing oversight of the provider network and responsible for managing the total cost of care for members and clients.Ownership of local market unit cost targets, medical cost strategies, risk adjustment and contract deviation; and collaboration with regional VBC teams responsible for negotiation and administration of VBC contracts.Accountability for efficient contracting efforts across all provider types securing favorable unit cost positioning. Ensuring alignment to core processes for contract administration, for example, accurate and timely contract loads.Providing strategy and collaborating 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.Overseeing and ensuring effective development and management of the provider network functions including provider relations, reimbursement, payment innovation, health care value transformation and network administration. Setting market network strategy for fee for service contracting as well as value-based care/population health.Responsibility 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.Setting 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.Managing their local market provider relations, utilizing support structure to drive improved provider experience resulting in favorable unit cost positioning and innovative reimbursement structures to drive favorable positioning.Managing medical costs in close partnership with Clinical Functions and drives change to improve cost structure partnership.Developing and maintaining strong relationships with the Market President, Market CFO, Chief Medicare Officer (CMO) and Segment Leads to ensure alignment in developing and executing strategies that drive profitable membership growth.Partnering with sales to develop and execute customer specific network solutions to retain and win critical plan sponsors.Representing Aetna to legislative, regulatory and community partners.Consulting with the Market Compliance Consultant on state network filings and supporting the work with resources aligned in the local markets.Active engagement in the development and assessment of internal policies impacting Providers and Network Operations.Supporting CVS Health in attracting, retaining, and engaging a diverse and inclusive consumer-centric workforce that delivers on our purpose and reflects the communities in which we work, live, and serve.Required Qualifications:10+ years of healthcare network & contracting experience with a national health plan or large hospital system.Medical Economics experience valued.Proven people leadership skills.Strong understanding of fee for service and value-based contracting with medical and behavioral health systems and physician groups.Knowledge of industry segments including Commercial, ACA, Medicare, and Medicaid.Strong presentation and communication skills; ability to consult as well as negotiate contracts.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 track record of delivering results.Must be based in Florida or Georgia or willing to relocate.Demonstrate a commitment to diversity, equity, and inclusion through continuous development, modeling inclusive behaviors, and proactively managing bias.Education:Bachelor's degree is required.Pay Range:The typical pay range for this role is: $157,800.00 - $363,936.00This 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.
In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long-term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off (“PTO”) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.
For more detailed information on available benefits, please visit
Benefits | CVS Health .We anticipate the application window for this opening will close on: 10/30/2024.Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
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Our Heart At Work Behaviors support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.Position Summary:At Aetna, our health benefits business, we are committed to helping our members achieve their best health in an affordable, convenient, and comprehensive manner. Combining the assets of our health insurance products and services with CVS Health’s unrivaled presence in local communities and their pharmacy benefits management capabilities, we’re joining members on their path to better health and transforming the health care landscape in new and exciting ways every day.Aetna is recruiting for a Chief Network Officer who is responsible for local market strategic and operational leadership, development, and medical expense performance along with implementation of network strategies and provider relations. Success will be measured by the executive’s ability to meet the organization’s growth, profitability, affordability, product, and local market needs across all segments. This market leader will be responsible for the Florida and Georgia markets and report to the VP, Regional Network Leader.You’ll make an impact by:Leading the team that is accountable for leading and implementing Network strategy focused on optimizing local market network performance and cost, delivering strategic network goals. Ensuring all contracting efforts with hospital/provider systems deliver appropriate outcomes.Directing oversight of the provider network and responsible for managing the total cost of care for members and clients.Ownership of local market unit cost targets, medical cost strategies, risk adjustment and contract deviation; and collaboration with regional VBC teams responsible for negotiation and administration of VBC contracts.Accountability for efficient contracting efforts across all provider types securing favorable unit cost positioning. Ensuring alignment to core processes for contract administration, for example, accurate and timely contract loads.Providing strategy and collaborating 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.Overseeing and ensuring effective development and management of the provider network functions including provider relations, reimbursement, payment innovation, health care value transformation and network administration. Setting market network strategy for fee for service contracting as well as value-based care/population health.Responsibility 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.Setting 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.Managing their local market provider relations, utilizing support structure to drive improved provider experience resulting in favorable unit cost positioning and innovative reimbursement structures to drive favorable positioning.Managing medical costs in close partnership with Clinical Functions and drives change to improve cost structure partnership.Developing and maintaining strong relationships with the Market President, Market CFO, Chief Medicare Officer (CMO) and Segment Leads to ensure alignment in developing and executing strategies that drive profitable membership growth.Partnering with sales to develop and execute customer specific network solutions to retain and win critical plan sponsors.Representing Aetna to legislative, regulatory and community partners.Consulting with the Market Compliance Consultant on state network filings and supporting the work with resources aligned in the local markets.Active engagement in the development and assessment of internal policies impacting Providers and Network Operations.Supporting CVS Health in attracting, retaining, and engaging a diverse and inclusive consumer-centric workforce that delivers on our purpose and reflects the communities in which we work, live, and serve.Required Qualifications:10+ years of healthcare network & contracting experience with a national health plan or large hospital system.Medical Economics experience valued.Proven people leadership skills.Strong understanding of fee for service and value-based contracting with medical and behavioral health systems and physician groups.Knowledge of industry segments including Commercial, ACA, Medicare, and Medicaid.Strong presentation and communication skills; ability to consult as well as negotiate contracts.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 track record of delivering results.Must be based in Florida or Georgia or willing to relocate.Demonstrate a commitment to diversity, equity, and inclusion through continuous development, modeling inclusive behaviors, and proactively managing bias.Education:Bachelor's degree is required.Pay Range:The typical pay range for this role is: $157,800.00 - $363,936.00This 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.
In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long-term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off (“PTO”) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.
For more detailed information on available benefits, please visit
Benefits | CVS Health .We anticipate the application window for this opening will close on: 10/30/2024.Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
#J-18808-Ljbffr