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Aetna is now a CVS Health Company

MCD WV Administrator/Contract Liaison

Primary Location: Charleston, WV
Additional Locations: WV-Charleston
Aetna Better Health of WV (ABHWV) is honored to join the WV Department of Health and Human Services (DHHR) in its mission to keep children safe at home. ABHWV will welcome you to a dynamic team of mission driven individuals who believe that foster children deserve better. At the end of the day, this is about giving children a chance to thrive and supporting all families in our community.

Responsible for the overall delivery of the project(s). Creates and deploys winning product strategies and manages product portfolio to increase and retain Aetna membership. Oversees product strategy and management, ensures product strategies are integrated within company/business unit strategy and operational plans, and manages
staffing planning and development activities across teams.

Fundamental Components:
Responsible for overall delivery of a project(s).
Serves as a liaison with the Department during all phases of a contract.
Attends in person, upon Department request, meetings and hearings of legislative committees and interested governmental bodies, agencies and officers.
Establishes and maintains a positive client relationship.
Provides timely and informed responses to operational and administrative inquiries that arise.
Contributes to contractual, operational, and financial decisions, including, but not limited to, claims payment and provider relations/contracting.
Meets with Department staff or such other person(s) as designated by the Department on a regular basis to provide oral and written status reports and other information as required.
Able to respond to issues involving information systems and reporting, appeals, quality improvement, member services, service management, pharmacy management, medical management, care coordination, and issues related to the health, safety, and welfare of the member.
Ensures that each member has an ongoing source of care appropriate to his/her needs and a person or formally designated as primarily responsible for coordinating the services accessed by the member.
Maintains mastery-level understanding of Aetna/business unit strategy, customers, healthcare, and regulatory environment.
Analyzes, interprets, and builds information on customer trends, competitor moves, and product performance.
Generates unique and actionable insights to drive strategy.
Demonstrates mastery-level understanding of key drivers of product performance including holistic, integrative view of all other functions, i.e. pricing, sales, distribution, quoting, marketing, as well as other markets/segments, and Aetna business processes.
Advanced ability to manipulate data, understand patterns, and draw conclusions in a hypothesis driven approach to analysis.
Substantiates strategy with rigorous analysis and data/research, including milestones, success metrics, and objective, high-level benefits, e.g., membership, revenue, medical cost saving projections.
Mastery-level understanding of strategy implications in context of other products and member-facing tools.
Ensures team(s) product strategies are articulated in a compelling manner customized for different stakeholders including laying out facts / data in easily digestible format and drawing clear conclusions.
Leverages verbal and written communication to obtain buy-in from critical partners including prioritization and funding.
Provides direction, input and thought leadership into broader strategy work.
Builds and leverages strong relationships and remove barriers; support team in navigating and working across business areas Identify and help employees mobilize cross-functional support required to achieve business objectives, including areas of tactical and strategic support.
Take full accountability for the end-result, serves as product expert, and leverages all resources available to achieve objectives.

Background Experience:
At least 5 years’ experience in Medicaid managed care contract oversight.
At least 5 years experience with WV foster care system.
Substantial experience in health care, experience working with low-income populations, and cultural sensitivity.
Previous strategy consulting experience
Maintaining a strong relationship with the State partner, foster care providers, advocates and agencies.
Experience with the State judicial system.
Undergraduate degree in Business, Economics, Econometrics, Healthcare, Finance, or equivalent required. Master’s degree is preferred (such as, MBA, MPH, MPA, MPP).
Based in West Virginia.
Must have and impart a sense of urgency with key business partners.
Requires the ability to be innovative and resourceful in developing solutions.
Key skills are external focus, strategic thinking, communicating for impact, collaboration, and driving for results.

Additional Job Information:
Are you ready to join a company that is changing the face of health care across the nation? Aetna Better Health of West Virginia is looking for people like you who value excellence, integrity, caring and innovation. As an employee, you’ll join a team dedicated to improving the lives of our members. Our vision incorporates community-based health care that works. We value diversity. Align your career goals with Aetna Better Health of West Virginia, and we will support you all the way.

Required Skills:
Finance - Delivering Profit and Performance, Leadership - Driving Strategic and Organizational Agility, Sales - Knowing Customers

Desired Skills:
Finance - Servicing Customers Profitably, Leadership - Developing and Executing Strategy, Service - Creating a Differentiated Service Experience

Functional Skills:
Administration / Operation - Management: < 25 employees, General Management - Multi-functional management: < 25 employees, Government Relation - State, Information Management - Data acquisition, data management, programming and documentation, Leadership - Act as company spokesperson to external constituents, Network Management - Network market leadership

Technology Experience:
Desktop Tool - Microsoft Outlook, Desktop Tool - Microsoft SharePoint, Desktop Tool - Microsoft Word, Desktop Tool - TE Microsoft Excel

Potential Telework Position:

Percent of Travel Required:
10 - 25%

EEO Statement:
Aetna is an Equal Opportunity, Affirmative Action Employer

Benefit Eligibility:
Benefit eligibility may vary by position. Click here to review the benefits associated with this position.

Candidate Privacy Information:
Aetna takes our candidate's data privacy seriously. At no time will any Aetna recruiter or employee request any financial or personal information (Social Security Number, Credit card information for direct deposit, etc.) from you via e-mail. Any requests for information will be discussed prior and will be conducted through a secure website provided by the recruiter. Should you be asked for such information, please notify us immediately.

Click To Review Our Benefits (PDF)


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