Chief Operating Officer, Aetna Better Health of Louisiana

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.
 
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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.

Aetna Better Health of Louisiana is seeking an experience leader with vast operational knowledge of government programs such as Medicaid, Medicare and Dual Eligible for its state-wide managed Medicaid business in the role of Chief Operating Officer (COO). The Chief Operations Officer has the responsibility for overseeing all high-level operational activities of various functional areas, beyond traditional service operations, which may include Claims, Provider Services, Information Technology, Grievance and Appeals, Member Services, and Medical Management for our state-wide managed Medicaid business.  The ideal leader is strategic, committed to developing employees, and relentlessly pursuing change that is best for the organization and its customers.  The COO will be required to oversee the Medicare and Long-Term Care lines of business as well. This position will assist the Plan CEO in the successful growth and performance, including financial management of the Plan as well as interface, collaborate and work cooperatively with corporate office functional leaders and centralized shared services business departments.  The COO is a valued leader in the organization and an extension of the CEO both within the Plan and externally with the regulatory agencies and other state department.

You’ll make an impact by:

• Providing day-to-day leadership and management to a service organization that mirrors the mission and core values of the company.

• Responsibility for driving the Plan to achieve and surpass performance metrics, profitability, and business goals and objectives. Leading and managing all operational activities of various functional areas, beyond traditional service operations, which may include Claims, Encounters, Provider Services, Data Management, Information Technology, Members Services, Network, Program Integrity, and Enrollment.

• Responsibility for employee compliance with, and measurement and effectiveness of all Business Standards of Practice including Project Management and other processes internal and external.

• Providing timely, accurate, and complete reports on the operating condition of the Plan.

• Developing policies and procedures for assigned areas and ensures that other impacted areas, as appropriate, review new and changed policies.

• Assisting the Plan leader in collaborative efforts related to the development, communication and implementation of effective growth strategies and processes.

• May be required to spearhead the implementation of new programs, services, and preparation of bid and grant proposals.

• Collaborating with the Plan management team and others to develop and implement action plans for the operational infrastructure of systems, processes, and personnel designed to accommodate the rapid growth objectives of the organization.

• Assisting in defining marketing and advertising strategies within state guidelines.

• Participating in the development and implementation of marketing policies for the Plan and ensures their compliance with program regulations.

• Aiding in preparation and review of budgets and variance reports for assigned areas.

• Working cooperatively with Network Development team in the development of the provider network.

• Serving as a liaison with regulatory and other state admin