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, Chief Network Officer who is responsible for the strategic, operational leadership and development along with implementation of network strategies and provider relations. Success will be measured by the executive's ability to meet the organization's growth, affordability, product, and the local market needs. This leader will be responsible for the Keystone/Capitol market which covers the states of Pennsylvania, Washington DC, Virginia, and Maryland.You'll make an impact by:

• Leading the team that is accountable for leading and implementing the Network strategy focused on optimizing local market network performance and cost, delivering strategic network goals. Ensuring all contracting efforts with hospital/provider systems deliver appropriate outcomes.
• Directing oversight of the provider network and responsible for managing the total cost of care for members and clients.
• Ownership of local market specific unit cost targets, medical cost strategies, negotiation, and administration of VBC contracts, risk adjustment and contract deviation.
• Accountability for lowest cost contracting efforts across all provider types. Ensuring alignment to core processes for contract administration for example, accurate and timely contract loads.
• Providing strategy and collaborating 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.
• Cultivating strategies to improve the health care experience for members and for improving the experience of providers.
• 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.
• Overseeing and ensuring effective development and management of the provider network functions including provider development, provider relations, reimbursement, payment innovation, health care value transformation and network administration.Setting market network strategy for fee for service contracting as well as value-based care/population health.
• Responsibility 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.
• Setting the unit cost budget for contracting across all provider types and product segments, driving innovation across traditional and non-traditional models for all lines of business, coordinating expansion activities, and driving towards local market and national goals.
• Managing the local market provider relations and directs implementation and operations of Value Based Contracting arrangements.
• Managing medical costs in close partnership with Clinical Functions and driving change to improve cost structure partnership.
• Developing and maintaining strong relationships with the Market President, Market CFO, Medicare GM and Segment Leads to ensure alignment in developing and effecting strategies that drive profitable membership growth.
• Partnering with sales to develop and execute customer specific network solutions to retain and win critical plan sponsors.
• Representing Aetna to the legislative, regulatory and community partners.
• Consulting with the Market Compliance Consultant on state network filings and assigning a Network Lead to support the filing.
• Active engagement in the development and assessment of internal policies impacting Providers and Network.
• 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.

• 15+ years of healthcare network & contracting experience. Medical Economics experience will be valued.
• Experience leading and developing people, preferably leading managers. Proven team leadership experience - leadership skills to build high-performing teams, manage and develop talent, influence, and impact a broad set of stakeholders, engage, and inspire others, and lead by example. Ability to lead teams and drive performance in a dynamic and fast-paced environment.
• Strong understanding of fee for service and value-based contracting with hospital systems.
• Knowledge of Commercial, IFP, Medicare, Medicaid, and Behavioral Health.
• Excellent negotiation, communication, and relationship management skills.
• Strong analytical skills including root cause analysis.
• Strategic thinker with the ability to analyze data, identify trends, and make informed decisions.
• Skilled at collaborating and working across a complex matrixed organization.
• Expertise in market level management, cost drivers and levers, and knowledge of economic, regulatory and marketplace issues.
• Possess exceptional leadership skills and transformational experience with a proven track record of delivering results.
• Should reside in the Keystone/Capitol market (Pennsylvania, Washington DC, Virginia, or Maryland).
• Demonstrate a commitment to diversity, equity, and inclusion through continuous development, modeling inclusive behaviors, and proactively managing bias.