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Exec Dir, Aetna Commercial Compliance

Primary Location: Hartford, CT
Additional Locations: CT-Hartford
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Description:

This position is a leadership role for the Company regarding compliance discussions with regulatory authorities. The incumbent will lead and direct a team of compliance professionals responsible for coordinating regulatory activity in U.S. states and territories. This team interacts with federal and state regulators regarding examinations activity and inquires as well as the implementation of laws and regulations. The incumbent will also manage individuals who support business areas working on Aetna Commercial Plans as they develop and deploy risk mitigation strategies and correct and prevent issues. The position collaborates with Aetna business leaders and colleagues to ensure business accountability to remediate issues and strengthen controls. In addition, the position will work closely with business leadership to ensure there is a good understanding of and commitment to ethical and compliance standards.
This role will report to the enterprise Vice President, Compliance Operations and will ideally be located in Hartford CT.



Fundamental Components:
  • Advise Compliance leadership on legal and regulatory matters related to compliance with applicable laws, regulations and contract requirements based on interactions with Federal and State regulators, examining entities and business partners.
  • Partner with aligned business functions to ensure internal controls are implemented to effectively prevent, identify and resolve issues quickly and effectively.
  • Manage Senior Directors responsible for regulatory interaction including examinations and response to regulatory inquiries.
  • Manage individual contributor who develops certain Compliance reports, such as Aetna legal entity audit committee reports, state compliance dashboard, etc.
  • This role is a member of the Regulatory Review Board and participates in the Aetna legal entity audit committee meetings.
  • Provide leadership of process to monitor fulfillment of conditions related to States’ approval of CVS Health’s acquisition of Aetna. Develop and distribute monthly status report to Enterprise Leaders.
  • Provide Internal Audit a view of regulatory risk areas in a regular cadence.
  • Lead a Commercial Business Compliance Office (BCO) team responsible for partnering with business units to implement the requirements of new laws, regulations and settlement agreements.
  • Partner with Legal and the Compliance Risk Administration team to perform periodic compliance risk assessments of Aetna Commercial, Institution and Specialty Product businesses


Background Experience:
  • A minimum of 15+ years of relevant work experience in Health Insurance regulatory or operations, preferably at Aetna, i.e. health care laws, health insurance and related product operations, regulatory standards, and management of change and controls process.
  • Strong understanding of Federal and State regulatory environments and professional work experience with or for Federal and State agencies.
  • Proven success in a leadership role.
  • Strong knowledge of the life cycle of commercial health insurance and related products.
  • Proven ability to influence to other functional areas, leaders and external parties, as applicable, to ensure appropriate compliance solutions and controls are implemented; strong negotiation skills.
  • Executive presence and proven communications skills including ability to collaborate with and influences senior level executives/key decision makers; this position requires a high level of professionalism


Required Skills:
Leadership - Collaborating for Results, Leadership - Creating Accountability, Leadership - Driving a Culture of Compliance

Potential Telework Position:
No

Percent of Travel Required:
0 - 10%

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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