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CEO, Medicaid Health Plan

Primary Location: Downers Grove, IL
Additional Locations: IL-Downers Grove
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Description:
This full-time position is the top executive position for Aetna Better Health of IL Medicaid Medicare Plan and is the lead contact for all communication between the Illinois Department of Health Care & Family Services (HFS) and the Centers for Medicare & Medicaid (CMS). The Chief Executive Officer (CEO) has accountability and authority for administration and implementation of all contract requirements, including ownership of profit and loss: meeting revenue, maintaining and growing membership, network adequacy, member and provider satisfaction and operating income plans. The CEO is responsible for the daily conduct, compliance and operations of the IL Medicare Medicaid Alignment Initiative. The primary office location is Downers Grove, Illinois. Some travel is expected and can include in & out-of-state meetings, in-state and local commuting to meet and engage with key stakeholders inclusive of, but not limited to State Regulators, Hospitals, Home Health Agencies, Nursing Facilities, FQHCs and individual provider networks.



Fundamental Components:
Establishes and maintains a system for reviewing/assessing the State contract, for reporting regarding the contract, and for suggesting actions to improve services to the State agency. - Will be 100 percent assigned to the contract, with overall responsibility for the administration of the contract and daily operations, including overseeing the budget and accounting system. - Communicates State agency requirements for program implementations; coordinates with internal resources to implement contract requirements; communicates ongoing implementation progress with representatives of the State and regulatory agencies. - Assists representatives of the State agency, as requested, regarding issues related to all administrative services. - Achieves and maintains full understanding of the contract/requirements, programs and policies, including service scope, special service features, history of service issues, and contact with State representatives. - Implements contract requirements. - Oversees the day-to-day operations of the staff (including Medical Director and Compliance Officer). - Manages operations within the prescribed budget. - Attends multiple State level meetings. - Macro-environmental view of competitive landscape, regulatory and legislative impact to the plan. - Develops safety net provider relations, provider services, community involvement and promotes awareness of the plan. - Strategic planning and development of operating plan to support business operations. - Builds commitment and support of matrix partners to achieve shared business goals. - Works with management team to develop quality improvement and cost savings initiatives. - Motivates and leads a high-performance management team, recruiting, training, developing and retaining experienced staff.



Background Experience:
Minimum of 10 years progressive management experience in managed care or a health care related position, with demonstrated experience with all aspects of business development and financial management within a medical delivery and/or managed care systems. - Effective technical skills regarding health plan administration, medical management concepts and underwriting.




Potential Telework Position:
No

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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