Chief Health Services Officer - Aetna Better Health of IL - Medicaid Health Plan Leadership
Join CVS Health: Transforming Healthcare with Heart At CVS Health, we're driven by a singular purpose: Bringing our heart to every moment of your health. As a leading health company, we're committed to delivering human-centric healthcare solutions that make a meaningful difference in people's lives. Our Heart At Work Behaviors guide us in transforming our culture and innovating to make healthcare more personal, convenient, and affordable. Aetna Better Health of Illinois: Enhancing Quality and Population Health Outcomes Aetna Better Health is Aetna's Medicaid managed care plan, with over 30 years of experience in managing the care of individuals with diverse healthcare needs. We're dedicated to enhancing quality and population health outcomes while integrating CVS assets to bring accessible healthcare to our members. As a Chief Health Services Officer at Aetna Better Health of Illinois, you'll play a critical role in shaping our health services operations and ensuring we're optimally competitive in the IL Medicaid market. Job Summary We're seeking an exceptional Chief Health Services Officer - Aetna Better Health of IL to lead our health services operations and serve as a trusted advisor to the CEO and health plan leadership team. As a seasoned executive with a strong background in medical management, you'll oversee centralized medical management functions, develop and implement care programs, and ensure compliance with regulatory requirements. This is a unique opportunity to make a lasting impact on the lives of our members and contribute to the growth and success of our organization. Key Responsibilities: Provide strategic leadership and oversight of health services operations, including Utilization Management, Care Management, and Quality initiatives. Develop and implement care programs that address social determinants of health, behavioral health, and physical health integration. Ensure compliance with Illinois' regulatory requirements, including Medicaid and accreditation standards. Serve as the Single Point of Contact (SPOC) for health services operations between the health plan and regulators. Represent the health plan as the health services Subject Matter Expert (SME) for external stakeholders, including providers and state officials. Analyze data and develop insights to inform health services operations and drive business decisions. Collaborate with cross-functional teams, including clinical program vendors, to drive innovation and improvement. Develop and execute strategic and tactical business plans to achieve health plan goals and objectives. Requirements: To succeed in this role, you'll need: 10+ years of experience in medical management leadership roles, including experience within managed care organizations. 5+ years of Medicaid experience, preferably in the State of Illinois. Experience with data analytics reporting and analysis used to serve managed care populations. Strong influencing skills to effectively work across senior stakeholders to drive alignment and results. Extensive experience leading cross-functional initiatives and driving innovation. Demonstrated success in collaboration, teamwork, and execution across multiple departments to deliver results. Strong decision-making, analytical, and organizational skills. Ability to develop and execute strategic and tactical business plans. Advanced degree preferred; specialized training or relevant professional qualification will be considered. Preferred Qualifications: We'd love to see: Registered Nurse, preferably in the state of IL. Illinois state resident. Interaction with the state with respect to Medicaid programs, contract requirements, reporting, and deliverables. What We Offer At CVS Health, we're committed to putting our heart into caring for our colleagues and our communities. Here are just a few benefits you can expect: Competitive salary: $100,000.00 - $231,540.00 per year. Opportunities for career growth and professional development. Comprehensive medical, dental, and vision benefits. 401(k) retirement savings plan and Employee Stock Purchase Plan. Fully-paid term life insurance plan and short-term and long-term disability benefits. Paid Time Off (PTO) and paid holidays throughout the calendar year. CVS store discount and discount programs with participating partners. Why Join Us? At CVS Health, we're passionate about transforming healthcare and making a positive impact on the lives of our members. As a Chief Health Services Officer at Aetna Better Health of Illinois, you'll have the opportunity to: Lead and shape our health services operations to drive business results and improve member outcomes. Collaborate with a talented team of healthcare professionals who share our purpose and values. Contribute to the growth and success of our organization and make a lasting impact on the lives of our members. Ready to Apply? If you're a motivated individual ready to contribute to a thriving team, we encourage you to apply now! We're excited to review your application and discuss this opportunity further. Apply for this job Apply tot his job