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VP, Medicare Duals Segment

Primary Location: Hartford, CT
Additional Locations: CT-Hartford
Responsible for leading Aetna’s rapidly expanding Duals business across the Aetna enterprise. Establish and lead the overall governance process for the business to optimize growth, profitability and regulatory compliance.

Fundamental Components:
Manages P&L for Duals business within Aetna’s Medicare business segment.
Develop and execute a mulch-year, growth strategy for the Duals business across both the Medicare and Medicaid businesses. Strategy should include product evaluation, sales, distribution, network design, integrated clinical model, and core operations
Ensures alignment and clearly defined objectives exist and are executed upon for all Aetna functions supporting the Duals business working (including operations, marketing, sales, revenue management, finance, compliance, local markets, etc.)

Works with Medicaid and Medicare teams to ensure program requirements are met from RFP/ application through implementation. Fosters continuous collaboration between the segments to sustain active engagement, leverage best practices, and establish consistency across the spectrum of Dual/DSNP products.
Establishes and sets direction on where the Duals product should be offered geographically, including expansion and penetration objectives.
Partners with clinical organization to develop, implement, and maintain the appropriate Duals clinical model. Provides subject matter expertise and sets strategic direction related to the Model of Care.
Monitors external environment, evaluates conditions to identify and implement shifts in strategic direction as needed. Synthesizes information from Federal and state agencies to understand the Duals landscape both at the market and national level. Uses information to assess opportunities for Medicare/Medicaid product integration.
Tracks Duals growth, profitability, investment spend and performance against budget at both the local market and national level. Engages local and segment resources to optimize performance across a variety of functional areas.
Acts as coach/SME for product, operations, sales management, regulatory oversight, and performance reporting. Partners with Product, Chief Medicare Officers, Sales/Marketing, Service Operations, Clinical/Quality, Compliance, and Stars leadership to sustain direction and dialogue among functional owners to effectively manage the business.

Background Experience:
  • A minimum of 15 years health care experience
  • At least 10 years strong leadership and management experience in a complex organization that is positioned for growth and expansion.
  • Strong Medicare/Medicaid health plan experience, specifically Duals, DSNP & MMP knowledge
  • Demonstrated P&L experience running and growing a complex business
  • A proven track record of building, motivating and driving results
  • Strong financial acumen skills
  • Superior leadership and talent development skills
Experience leading and influencing in a large matrixed organization

Percent of Travel Required:
0 - 10%

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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