Aetna Executive Director, North Texas Markets & TexasHealth Joint Venture in Los Angeles, California
Req ID: 51114BR
Top leadership position providing strategic direction and leadership to sales and network teams to achieve market goals for assigned business, customer segments, products, and services in support of profitable growth. The successful candidate will interact and serve as the external client-facing leader in the North Texas market. Serves as a local spokesperson and coordinator for all market initiatives. Position will provide oversight to the Oklahoma, Northern Texas geographies and Texas Health joint venture.
Location: Dallas, TX
Develop the company strategy to address both short-term and long-term market potential and business opportunities Communicate the company s transformational market vision and strategy in bold and persuasive terms and gain buy-in within the organization and build support amongst partners Constructively challenge the conventional wisdom of accepted ways of doing things and will deeply understand the marketplace and the competitive environment. Continuous innovation of company value proposition to maintain differentiated leadership position. Sets, communicates, and executes operational strategy and performance measures in line with company, segment, region and market goalsEnsures achievement of sales and membership growth goals. Analyzes competitive environment to support and improve pricing, underwriting, and product development strategies as well as sales and service efforts.
Cultivates and maintains strong relationships with all constituents (producers, plan sponsors, providers, customers, and regulatory agencies).Provides comprehensive understanding of hospital and physician financial issues and how to leverage technology to achieve quality and cost improvements for both payers and providers. Provides oversight of network and geographic strategies across continuum from traditional fee-for-service to value-based contracting to Accountable Care Organizations for all business segments. Responsible for the oversight of negotiations including competitive and complex contractual relationships with providers according to pre-determined internal guidelines and financial standards. Manages provider compensation/reimbursement and pricing development activities for understanding and managing medical cost issues and initiating appropriate action. Works cross-functionally to execute network strategies with local networks and Accountable Care organization. Provide oversight of the TexasHealth joint venture leadership team(s); includes by not limited to ensuring alignment with Aetna vision and values; collaborating across both organizations.Maintains accountability for specific medical cost initiatives to achieve target medical/Rx trend results with focus on network price/synergies, scoreable actions and medical cost management initiatives. Manages local sales, account management, and network teams; responsible for driving new distribution strategies and rigorous financial management. Building and growing the company within current and targeted expansion geographies leveraging company and owner assets to rapidly scale business and deliver on financial goals. Conducting financial analysis, forecasting, revenue modeling, and valuation of the company at various developmental stagesInitiates legal reviews as needed; ensures all required reviews are completed by appropriate functional areas. Drives compliance in all market business. Builds strong collaboration and demonstrate effective influencing skills with critical matrix partners across Underwriting, Actuary, Finance, Product, HCM/Clinical, Compliance, Marketing, Medical Economic Unit and Service.Serve as the organization s representative and will leverage company s transformational vision and capabilities to influence a wide array of professional, policy and regulatory circles
BACKGROUND/EXPERIENCE desired:• 10+ years of general management, sales and/or network management experience• In-depth knowledge of managed care business, regulatory /legal requirements, products, programs, strategy and objectives.• Expertise in Health Insurance, Population Health, including analytics, care management, payer/provider network contracting and management and risk management, especially involving value-based care relationships. • Experience in working with ACOs, Patient-centered Medical Homes and Patient Centered Specialty Practices.
Bachelor's degree of equivalent experience. An MBA or equivalent advanced degree is preferred.
Licensure as required by state.
Functional - Leadership/Lead a complex or multifunctional organization/1-3 Years
Functional - Leadership/Profit & Loss Accountability/1-3 Years
Functional - Network Management/Network market leadership/4-6 Years
Functional - Sales & Service/Strategy development/4-6 Years
ADDITIONAL JOB INFORMATION
Aetna is about more than just doing a job. This is our opportunity to re-shape healthcare for America and across the globe. We are developing solutions to improve the quality and affordability of healthcare. What we do will benefit generations to come.
We care about each other, our customers and our communities. We are inspired to make a difference, and we are committed to integrity and excellence.
Together we will empower people to live healthier lives.
Aetna is an equal opportunity & affirmative action employer. All qualified applicants will receive consideration for employment regardless of personal characteristics or status. We take affirmative action to recruit, select and develop women, people of color, veterans and individuals with disabilities.
We are a company built on excellence. We have a culture that values growth, achievement and diversity and a workplace where your voice can be heard.
Benefit eligibility may vary by position. Click here to review the benefits associated with this position.
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Job Function: Health Care