AVP, Chief Network Operations - First Health

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Position Summary

First Health is a large, national Preferred Provider Organization (PPO) network owned by Aetna, which provides members access to discounted healthcare services from a broad network of doctors, hospitals, and other providers across the United States. While it is owned by Aetna, First Health functions as a separate subsidiary, specializing in connecting its payer clients and their members to a nationwide network of doctors and facilities at negotiated rates to help manage costs and improve access to care.

Aetna is seeking an AVP, Network and Operations to lead the First Health business with full P&L responsibility. This role encompasses the development of annual budgets, quarterly forecasts, and long-term strategic planning. This leader will oversee network management and provider relations, while also crafting a forward-looking vision to drive sustained revenue growth. This leader will manage a total team of 178 professionals and be accountable for delivering $100 million in annual revenue.

Key Responsibilities

• Responsibility for full P&L including building of annual budgets, quarterly forecasting and strategic plans.

• Partnering with the Aetna network executive team to ensure network maintenance and development is integrated into the broader network roadmap.

• Leading the strategic development and expansion of the company's provider network by evaluating potential network providers, negotiating contracts, and establishing relationships with healthcare providers, hospitals, and clinics.

• Overseeing the negotiation, development, and management of contracts with network providers.

• Facilitating and tracking key performance indicators (KPIs) to assess provider performance, identify areas for improvement, and implement strategies to enhance network performance.

• Establishing positive and collaborative relationships with network providers, facilitating effective communication, and ensuring mutual understanding of expectations and contractual obligations.

• Ensuring stringent compliance with regulatory requirements and accreditation standards related to provider network management.

• Communicating with internal stakeholders, such as legal, finance, and operations, to ensure contracts are structured to meet quality, financial, and operational goals while complying with regulatory requirements.

• Implementing network strategies aligned with the organization's goals and market dynamics by evaluating market trends, competitive landscape, and patient needs to shape the network development strategy and optimize provider network composition.

• Managing operational aspects of the team, including budget, performance, and compliance, and implementing workforce and succession plans to meet business needs.

• Overseeing performance expectations, provides guidance and feedback, and promotes a culture of continuous improvement and employee engagement.

Required Qualifications

The candidate will have a strong work ethic, be a self-starter, and be able to be highly productive in a dynamic, collaborative environment. This position offers broad exposure to many aspects of the Aetna’s business, as well as significant interaction with executive leadership. The candidate will be expected to have the following key attributes:

• 20+ years of managed care experience, with a strong track record of leading and managing high‑performing teams.

• Proven experience contracting with providers and hospital systems.

• Strong analytical capabilities, including root cause analysis and data‑driven problem solving.

• Demonstrated ability to think strategically and translate strategy into action.

• Highly effective in execution and delivery, including planning, implementation, and operational support.

• Adept collaborator with a strong orientation toward teamwork.

• Demonstrated mastery of problem‑solving and sound decision‑making.

• Strong growth mindset, with agility and a commitment to developing self and others.

• Skilled