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Aetna is now a CVS Health Company

Chief Operating Officer, Medicaid Operations

Primary Location: Overland Park, KS
Additional Locations: KS-Overland Park
Responsible for increasing member and provider satisfaction, retention, and growth by efficiently delivering competitive services to members and providers through a fully-integrated organization staffed by knowledgeable, customer-focused professionals supported by exemplary technologies and processes. The Chief Operating Officer is responsible for leading and managing all hands-on operational aspects and activities of various functional areas which may include: Claims, Provider Services, Information Technology, Grievances and Appeals, Member Services, Medical Management and the Medicaid and Long- Term Care lines of business. Assists the Plan leader in the successful growth and performance of the Plan. The Chief Operating Officer also interfaces, collaborates and works cooperatively with corporate office functional leaders and centralized business departments.

Fundamental Components:
Provides day-to-day leadership and management to a service organization that mirrors the mission and core values of the company. Interfaces with corporate office staff as required.
Responsible for driving the Plan to achieve and surpass performance metrics, profitability, and business goals and objectives.
Responsible for oversight and coordination of all subcontractors and delegated entities.
Responsible for the Delegation Oversight (sub)-Committee, coordinating annual audits, facilitating joint operational meetings between the plan and its subcontractors and interfacing with other internal business units impacted by subcontractors.
Responsible for employee compliance with, and measurement and effectiveness of all Business Standards of Practice including Project Management and other processes internal and external. Provides timely, accurate, and complete reports on the operating condition of the Plan. Develops policies and procedures for assigned areas. Ensuring that other impacted areas, as appropriate, review new and changed policies.
Assists the Plan leader in collaborative efforts related to the development, communication and implementation of effective growth strategies and processes. May be required to spearhead the implementation of new programs, services, and preparation of bid and grant proposals.
Assists in defining marketing and advertising strategies within State guidelines. Participates in the development and implementation of marketing policies for the Plan, and ensures their compliance with program regulations.
Provides assistance in preparation and review of budgets and variance reports for assigned areas.
Works cooperatively with Network Development team in the development of the provider network. Acts as client-care officer through direct contact with all stakeholders. Serves as a liaison with regulatory and other state administration agencies, and communicates activity to CEO and reports back to Plan.

Background Experience:
10+ years work experience that reflects a proven track record of proficiency in the competencies noted.
Recent and related managed health care experience.
Medicaid experience required.

Ability to work closely with client service, operations, and investment personnel
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.
Proven leadership and negotiation skills.
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

Demonstrated leadership with relevant initiatives: Business process, enterprise business project management/consulting, financial strategic planning and analysis, mergers and acquisitions, strategic planning, risk management.

Required Skills:
Finance - Delivering Profit and Performance, Leadership - Engaging and Developing People, Sales - Knowing Markets

Desired Skills:
Finance - Servicing Customers Profitably, Leadership - Developing and Executing Strategy

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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