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Chief Operating Officer (67666BR)

Primary Location: Dallas, TX
Additional Locations: TX-Dallas
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Description:
Leadership of operational functions in Texas based managed care plan, including but not limited to network management, claims, provider services, complaints and appeals, member services, reporting, and implementation of new programs. Executes local strategic and operational plan in support of business segment objectives and initiatives. Plans, directs and implements procedures that will assure operational excellence. Responsible for the quality and effectiveness of own team and related teams, identifying and resolving technical, operational and team problems. Manages a team of professional employees and/or supervisors.


Fundamental Components:
  • Serves as a key member of the leadership team in the locally based Medicaid managed care plan. Provides strategic and tactical leadership to network management, claims, provider services, complaints and appeals, member services, reporting, and implementation of new programs.
  • Establishes a clear vision aligned with company goals and values; sets specific challenging and achievable objectives and action plans; motivates others to balance customer needs and business success; challenges self and others to look to the future to create quality products, services, and solutions.
  • Develops, monitors and reviews performance reports and service performance trends and recommends specific actions or remedies as necessary.
  • Develops and maintains strong collaborative relationships within operations as well as with medical management, quality, and compliance.
  • Develops, trains, evaluates, and coaches staff to provide cost effective claim processing and claim and customer service while ensuring that quality standards are met.
  • Assesses individual and team performance on a regular basis and provide candid and timely developmental feedback; monitors training plans and ensure training needs are met.

  • Attracts, selects, and retains high caliber, diverse talent able to successfully achieve or exceed business goals; builds a cohesive team that works well together.
  • Creates and maintains tools, job aids, and training materials to help employees in their efforts to resolve issues and improve their relationship with customers.
  • Collects, analyzes and reports on operations information in support of process, systems, and policy redesign.
  • Effectively applies and enforces Aetna HR policies and practices, i.e. FML/EML, Attendance, Code of Conduct, and Disciplinary Guidelines. Effectively manages cross-functional projects that support the business strategy.


Background Experience:
  • 10+ years work experience that reflects a proven track record of proficiency in the competencies noted.
  • Medicaid experience
  • Ability to work collaboratively across many teams, prioritize demands from those team, synthesize information received, and generate meaningful conclusions.
  • Ability to conceive innovative ideas or solutions to meet clients requirements.
  • Excellent communication and relationship management skills. Express thoughts in an organized and articulate manner.
  • Listen very effectively and build a climate of trust and respect with prospective and existing clients and the consulting community.
  • Ability to work closely with client service, operations, and investment personnel.
  • Proven leadership and negotiation skills.
  • Demonstrated leadership with relevant initiatives
  • Business process, enterprise business project management/consulting, financial strategic planning and analysis, strategic planning, risk management.
  • Recent and related managed health care experience. Bachelor's degree required; Master's degree preferred.


Potential Telework Position:
No

Percent of Travel Required:
25 - 50%

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

Benefit Eligibility:
Benefit eligibility may vary by 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.

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