CVS Health Chief Network & Operations Officer in New York, New York
The Chief Network Officer is a member of the senior leadership team within the market.This individual will be accountable for the development and execution of the company’s strategy for improving health and care affordability. This leader will be charged with cultivating strategies to improve the health care experience for members and for improving the experience of providers. With direct oversight of the provider network, the CNO is ultimately be responsible for managing the total cost of care for members and customers. As a result, this leader must ensure the development and execution of strategic and operational goals for the care delivery. The CNO will be a thought leader that fosters deep collaboration with providers to facilitate joint design of innovative health improvement, member engagement, care management, and other initiatives that result in exceptional value and quality outcomes. This executive leader must possess exceptional leadership skills and transformational experience with a proven track record of delivering results.• Provide leadership to ensure development and attainment of strategic objectives and short- and long-term plans. • Oversee and ensure effective development and management of the provider network functions including provider development, provider relations, reimbursement, payment innovation, health care value transformation and network administration. • Lead, direct, and monitor teams and functions to manage total cost of care for all lines of business. • Collaborate with leadership and the board in the development and measurement of performance goals for quality, cost, growth, people and innovation for all areas of responsibility. • Provide strategy and direction in partnership with medical management, medical policy development, pharmacy management, quality improvement, population health, provider network development, provider contracting and management, accreditation, and management of clinical delivery assets. • Provide strategy, direction, and oversight of provider engagement functions of the company both clinical and nonclinical.At the market level will be accountable for leading and implementing the Network strategy focused on optimizing local market network performance (Commercial and Medicare) and cost, delivering on strategic network goals to drive profitable growth.The Chief Network Officer is responsible for setting market network strategy for fee for service contracting as well as value based care/population health.Responsible for network and operational infrastructure aligned to cost related levers and ensuring the market network(s) meet cost metrics, adequacy standards, network compliance regulations, and profitability goals.
Network Managemento Overall accountability for outcomes and deliverables for the market including segment growth objectiveso Ownership of local market specific MER, P-model, SAI, VBC strategy, and unit cost management o Ensure all contracting efforts with hospital/provider systems deliver appropriate outcomeso Support enterprise initiatives that leverage CVS integrated assets (e.g., Health Hubs, Aetna Connected Plan, etc)o Close collaboration and alignment with Clinicalo Represent Aetna to the legislative, regulatory and community partners; improve public relations; and, manage regional public policy issueso Consult with the Market Compliance Consultant on state network filings and assign a network lead to support the filing o Active engagement in the development and assessment of internal policies impacting Providers and Networkso Coach, mentor, and manage performance of team members; drive talent development and actively build bench strength for key roleso Identify network representatives as appropriate to participate in critical initiatives/ workgroups based on area of expertise to represent local market network perspectiveso Ensure all operational teams deliver objectiveso Manage the department budget including ensuring open positions are posted and filed timelyo Establish strong partnerships and collaborative model with customers and prospective customers, National Network, Product, Clinical, Finance, Marketing, Actuarial, and MEU across Commercial and Medicare segments to achieve objectives
• A minimum of 15 years of healthcare experience including contracting, medical economics and field or national network experience• Experience contracting with providers and hospital systems• Strong presentation and communication skills; ability to consult as well as negotiate• Strong analytical skills, including root cause analysis• Ability to think strategically• Skilled at collaborating and working across a complex matrixed organization• Management experience managing large, dispersed, highly skilled professional teams• Expertise in market level management, cost drivers and levers, and knowledge of economic, regulatory and marketplace issues
A Bachelor’s degree or equivalent experience required.
At Aetna, a CVS Health company, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.
We are committed to maintaining a diverse and inclusive workplace. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, gender, gender identity, age, disability or protected veteran status. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.