AVP, Business Operations - Medical Policy & Program Solutions - Military Veterans
at CVS Health
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.
Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.
Position Summary
At Aetna, our health benefits business, we are committed to helping our members achieve their best health in an affordable, convenient, and comprehensive manner. Combining the assets of our health insurance products and services with CVS Health’s unrivaled presence in local communities and their pharmacy benefits management capabilities, we’re joining members on their path to better health and transforming the health care landscape in new and exciting ways every day.
Aetna is recruiting for an AVP, Business Operations who is responsible for developing Medical Policy & Program Solutions (MPPS) through executing short and long term strategic and operational objectives across Commercial, Medicare and Medicaid lines of business. The role is also accountable for achieving financial and performance targets as well Commercial/Medicare/Medicaid Scoreable Action Item (SAI) Management. Performance is measured against financial goals which include revenue, established SAI targets and ROI.
You'll make an impact by:
Leading the strategy and drive operational efficiencies across Commercial, Medicare and Medicaid lines of business through programs that demonstrate significant cost savings for the enterprise.
Managing the primary relationship with key vendors and is actively involved in the contractual process ensuring that contract guidelines are met and managed appropriately.
Leading and executing the short and long term strategic and operational objectives for Commercial, Medicare and Medicaid lines of business - including achieving financial and performance targets.
Collaborating with executive leadership throughout CVS/Aetna and serves as the primary “face” of the business when meeting with key vendors to drive specific programs through contractual arrangements.
Responsibility for achieving cost savings through successful SAI implementation and management.
Developing and maintaining collaborative relationships with internal and external partners/customers/vendors; works to establish collaborative relationships by fostering excellent customer response and appropriate problem resolution.
Leading a team that promotes high standards of operational practice through advancement of policies, procedures, practice guidelines and alignment of clinical and non-clinical business processes and practices.
Leading, implementing, monitoring, and trending operational process and workflows by encouraging the use of industry best practices and standards as well as developing new processes that improve outcomes.
Leading recruitment and operating model development to meet business needs.
Developing and/or overseeing the implementation of staffing models that are consistent, cost effective and meet all compliance obligations.
Leading, developing, motivating, recognizing, and managing high-performing teams to meet organizational goals and objectives while effectively managing change.
Building an environment that supports professional development, mobility, and operational excellence.
Fostering a culture that accelerates our strategy through our Heart At Work Behaviors by keeping the customer and colleague as the central focus.
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, collaborative environment. This position offers broad exposure to all aspects of the company’s business, as well as significant interaction with all the business leaders.
15+ years of experience leading complex teams with knowledge of the healthcare system including medical management, claims, and provider networks.
Strong interpersonal and communication skills, effectively communicate key messages to executive leaders and internal/external stake holders.
Strong business and financial acumen.
Must have strong financial and operational expertise with a history of achieving results.
Ability to operationalize external vendor solutions to complex operational issues.
Established ability to develop innovative operational changes.
Demonstrate executive presence and ability to interact with internal and external constituents.
Ability to work a hybrid model (in office Tuesday / Wednesday / Thursday) in a nearby office or a remote work arrangement if not located near an office.
Ability to travel up to 20%.
Demonstrate a commitment to diversity, equity, and inclusion through continuous development, modeling inclusive behaviors, and proactively managing bias.
Education
Bachelor's degree required.
Pay Range
The typical pay range for this role is:
$157,800.00 - $363,936.00
This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. This position also includes an award target in the company’s equity award program.
In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off (“PTO”) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.
For more detailed information on available benefits, please visit Benefits | CVS Health
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
Hartford, CT
At CVS Health we are transforming health care with a shared purpose: Bringing our heart to every moment of your health™
With 300,000 dedicated colleagues including veterans, service members, Guard and Reserve, and military spouses, we are improving the health of communities across America.
We recognize the value of military service and know that the skills and experience our nation's veterans and military spouses possess are unparalleled. As a CVS Health colleague, you’ll find career opportunities across the organization and at every stage of your career. More important, your work will have an impactful purpose on someone’s life, including your own.
As an enduring partner with Military Spouse Employment Partnership for 20 years, we’re committed to providing long-term career potential, opportunity, and support for military spouses.
Corporate Fellowship Programs
Transitioning Service Members - For transitioning service members and Coast Guardsmen within 180 days of separation from service interested in SkillBridge programs, please reach out to YourNextMission@CVSHealth.com to learn about the career tracks that we host participants in.
Accommodation Statement
We provide reasonable accommodations to individuals with disabilities as needed. To request an accommodation – including a qualified interpreter, written information in other formats, translation or other services – please email AdviceandCounsel@cvshealth.com or call 877-805-9511. If you have a speech or hearing disability, please call 7-1-1 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.
EEO Statement
CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, sex/gender, sexual orientation, gender identity or expression, age, disability or protected veteran status or on any other basis or characteristic prohibited by applicable federal, state, or local law. We comply with the laws and regulations set forth in the following EEO is the Law Poster: EEO IS THE LAW and EEO IS THE LAW SUPPLEMENT.
Military Spouses - We offer programs throughout the year and have partnered with Hiring Our Heroes to offer a 12-week paid fellowship for military spouses. During this time, you will receive professional training and hands-on experiences across CVS Health enterprise to quickly build your network and showcase your skillset. If you are interested in Military Spouse Fellowship programs, please reach out to our partners at Hiring Our Heroes.