AVP, General Manager - Medicare

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.

Position Summary

Allina Health, as a health insurance provider, jointly-owned by Allina Health and Aetna, a CVS company, we’ve combined the power of an award-winning, local health system with a leading, national insurance company to provide an easier, more accessible and more valuable health insurance solution for Minnesotans.  We deliver empowered health insurance solutions that coordinate quality coverage and care around the needs of each member. We do this through health plans that connect Minnesota’s best doctors, specialists and care facilities to the coverage and benefits they need to provide the most effective coverage. The result is an easier, more accessible and more valuable health insurance solution for Minnesotans.  Our Allina Health/Aetna Medicare health plan currently serves approximately 27,000 Medicare Beneficiaries and generates more than $387M in annual revenue.

Aetna is recruiting for an AVP, General Manager who has Medicare market specific P&L accountability for Individual Medicare Advantage products, supporting sales and customer experience agendas in market as well as Go-To Market planning and acquisition cost. This position is the leader for market performance, cost structure and local execution of medical costs management, Medicare Stars, member engagement, compliance, and revenue integrity efforts for all Medicare Advantage products.  The Market GM will drive local product strategy and local market intelligence, be responsible for achieving target market position, market share growth, and drive cost structure reduction (SAIs) in collaboration with Medicare segment leadership, the market medical teams, Network Management teams and other related teams.

You'll make an impact by:

• Responsibility for supporting Medicare programs with short-and-long term profitability and growth of the health plan. 

• Spearheading the implementation of new contracts, programs, services, and preparation of bid and grant proposals.

• Responsibility for the overall financial performance and achievement of the budget of the Medicare plans within the Market.

• Collaboration and coordination with senior leaders of specific functional areas as assigned. Functional areas may include operations, sales, marketing, provider relations, network development, utilization management, and/or STARS/HEDIS quality improvement, and Revenue Integrity efforts. Coordinating and monitoring functional integration of these areas in cooperation with corporate departments to achieve planned business results.

• Leading all departments in the development, implementation and maintenance of policies and procedures to ensure compliance with the State and Federal regulatory requirements.

• Responsibility for the plan performance related to all required State and Federal audits.

• Responsibility for the management and organization of plan activities at the health plan as it relates to the Medicare business.

• Monitoring the budget in assigned functional areas and takes corrective actions when necessary.

• Leading and developing people, preferably leading managers.  Proven team leadership experience - leadership skills to build high-performing teams, manage and develop talent, influence, and impact a broad set of stakeholders, engage, and inspire others, and lead by example.  Ability to lead teams and drive performance in a dynamic and fast-paced environment.

• Partnering effectively within the team and across the organization to ensure strategic initiatives stay aligned to plan and elevate solutions to barriers and decisions needed to executive leaders at the highest levels of organization.

• Creating and executing a sustainable, and profitable-growth strategy.

• Accountability for working with Medicare segment functional areas for monthly results, bid execution and other MAO responsibilities.

• 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

The candidate will have a strong work ethic, be a self-starter, and be able to be highly productive in a dynamic, col