CEO, Aetna Better Health of North Carolina

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

Aetna Better Health is Aetna’s 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. That’s 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 high-performing 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 thought-leader and Aetna brand ambassador throughout the state, particularly through interactions with state agency leaders and community-based partners who serve the beneficiaries of Medicaid (TANF, LTC/LTSS, ABD) and CHIP programs.

You’ll make an impact by:

• Executing all market-specific 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 market-specific strategies to drive sustainable and profitable growth while setting the strategic direction to drive business growth.

• Possessing the state-specific 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, Governor’s offices, Secretaries, and top community leaders. 

• Transformational leader who is inspirational and can communicate Aetna’s vision, so others follow.  Driving a purpose-driven 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 RFP’s 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 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 eth