CEO Aetna Better Health of North Carolina

At CVS Health were building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.

As the nations leading health solutions company we reach millions of Americans through our local presence digital channels and more than 300000 purposedriven 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.

Position Summary

Aetna Better Health is Aetnas Medicaid managed care plan. Backed by over 30 years of experience managing the care of those with a broad array of health care needs our Medicaid plans have demonstrated that getting the right help when you need it is essential to better health. Thats why Aetna Medicaid plans include the guidance and support needed to connect our members with the right coverage resources and care. We are focused on enhancing quality and population health outcomes while integrating CVS assets to bring accessible healthcare to our members.

The Chief Executive Officer has the responsibility for growing and leading the Medicaid business in North Carolina. These responsibilities include leading all aspects of the plan including implementation of all contract requirements ownership of profit and loss by meeting revenue projections maintaining and growing membership developing a highperforming network and maintaining network adequacy. This leader will ensure Quality benchmarks are met articulating and executing initiatives that drive member and provider satisfaction and operating income plans. The CEO must ensure that the plan is following all state and federal requirements statutory mandates and NCQA requirements.

The CEO must develop a strong local leadership team (CFO COO CMO Community Development and Contract Managers) and ensure the state customer has familiarity with and confidence in this team. The CEO must strive to establish themselves as a thoughtleader and Aetna brand ambassador throughout the state particularly through interactions with state agency leaders and communitybased partners who serve the beneficiaries of Medicaid (TANF LTC/LTSS ABD) and CHIP programs.

Youll make an impact by:

• Executing all marketspecific state requirements through efficient programs and processes to meet or exceed all State contract expectations.

• Strategically drive successful results in a highly matrixed environment. Executing innovative marketspecific strategies to drive sustainable and profitable growth while setting the strategic direction to drive business growth.

• Possessing the statespecific knowledge and executive presence to command respect and establish a spirit of partnership in all regulatory interactions.

• Understanding the competitive landscape and state environment and translate that into business strategy. Collaborating closely with State Agency on strategies to improve and lead in market share across the statewide Medicaid footprint.

• Responsibility for building and maintaining trust and exceptional relationships with State Aetna leadership and colleagues. State stakeholders include state legislators/regulators Governors offices Secretaries and top community leaders.

• Transformational leader who is inspirational and can communicate Aetnas vision so others follow. Driving a purposedriven culture of collaboration talent development transparency and trust.

• Understanding the demographics health social risk and cultural profiles of the beneficiaries served under the contract.

• Planning for upcoming RFPs and lead the team with business development to be successful in winning business and having strong outcomes.

• Communicating state agency requirements to the Aetna organization for program implementations; coordinating with internal resources to implement contract requirements; communicating ongoing implementation progress with representatives of the State and regulatory agencies.

• Achieving and maintaining full understanding of the contract/requirements programs and policies including service scope special service features and history of service issues.

• Supporting CVS Health in attracting retaining and engaging a diverse and inclusive consumercentric workforce that delivers on our purpose and reflects the communities in which we work live and serve.

Required Qualifications

The candidate will have a strong work ethic be a selfstarter and be able to be highly productive in a dynamic collaborative environment. This position offers broad exposure to all aspects of the companys business as well as significant interaction with all the business leaders. The candidate will be expected to have the following key attributes:

• 10 years of progressive leadership experience in the healthcare industry with a minimum of 5 years at a senior executive level within a Medicaid managed care environment.

• Demonstrated success in strategic planning financial management operations optimization and regulatory compliance. Experience with RFP bid responses and orals presentations will be highly valued.

• Exceptional communication interpersonal and negotiation skills with the ability to build trust and consensus among diverse stakeholders.

• Thorough understanding of Medicaid managed care program policies and healthcare delivery systems.

• Commitment to promoting health equity addressing social determinants of health and improving the health and wellbeing of Medicaid beneficiaries.

• Strong knowledge of the Statespecific political landscape including State budget issues legislative leadership goals and areas of focus.

• Experience with all aspects of successful plan management is essential: Compliance and Regulatory Oversight Member Experience Provider Engagement Strategy Member Advocacy/ Outreach/ Retention Quality Management/Outcomes Value Based Contracting Population Health/Heath Equity/ SDOH Network Development and overall Operational .

• Proven ability to understand business strategies to set strategic direction and formulate/execute concise solutions to complex problems.

• Proven ability to work successfully within a matrix environment and influence internal stakeholders to achieve optimal results.

• Strong people management skills and proven experience leading teams through growth and change.

• Must be nimble and adaptable embrace change foster a learning culture empower the team and maintain a proactive and innovative mindset.

• Aligns with and promotes the values of CVS Health Innovation Collaboration Caring Integrity Accountability.

• Ability to work Hybrid Model (in office Tuesday / Wednesday / Thursday) in our North Carolina office. Must live in North Carolina or be willing to relocate to North Carolina.

• Demonstrate a commitment to diversity equity and inclusion through continuous development modeling inclusive behaviors and proactively managing bias.

Preferred Qualifications

A background of living in the state; connections with the North Carolina Department of Health and/or health system leadership and key provider group relationships.

Education

Bachelors degree required; Masters degree preferred.

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal state and local laws.

CVS Health requires certain colleagues to be fully vaccinated against COVID19 (including any booster shots if required) where allowable under the law unless they are approved for a reasonable accommodation based on disability medical condition religious belief or other legally recognized reasons that prevents them from being vaccinated.

You are required to have received at least one COVID19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.

CVS Health is committed to recruiting hiring developing advancing and retaining individuals with disabilities. As such we strive to provide equal access to the benefits and privileges of employment including the provision of a reasonable accommodation to perform essential job functions. CVS Health can provide a request for a reasonable accommodation including a qualified interpreter written information in other formats translation or other services through If you have a speech or hearing disability please call 711 to utilize Telecommunications Relay Services (TRS). We will make every effort to respond to your request within 48 business hours and do everything we can to work towards a solution.