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COO Aetna Better Health of PA

Primary Location: Philadelphia, PA
Additional Locations: PA-Philadelphia
The Chief Operations Officer is responsible for leading and managing all hands-on operational aspects and activities of various functional areas within the Plan which may include: Claims, Provider Services, Information Technology, Grievance and Appeals, Member Services, Medical Management and the Medicare and Long Term Care lines of business. Assists the Plan leader in the successful growth and performance of the Plan. The Chief Operations 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 employee compliance with, and measurement and effectiveness of, all Business Standards of Practice including project management and other processes, both 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.

(*) Collaborates with the Plan management team and others to develop and implement action plans for the operational infrastructure of systems, processes, and personnel designed to accommodate the rapid growth objectives of the organization.

(*) Participates in the development and implementation of marketing and outreach 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 a "face of the health plan" through direct contact with stakeholders.

(*) Serves as a liaison with various regulatory and state agencies in coordination with the CEO.

(*) Is expected to motivate and lead a high performance management team, foster a success-oriented, accountable environment within the Plan and recruit, train, develop, coach, and retain staff as needed.

(*) Assures compliance with and consistent application of laws, rules and regulations, company policies and procedures for all assigned areas.

(*) Prompt response with a sense of urgency/priority to customer requests with documented follow-through/closure.

(*) Assists as assigned or required in performing other duties, assignments and/or responsibilities.

Background Experience:
(*) 10+ years of work experience that reflects a proven track record of proficiency in the competencies noted.

(*) Ability to work collaboratively across many teams, prioritize demands from those teams, synthesize information received, and generate meaningful conclusions.

(*) Ability to conceive innovative ideas or solutions to meet client 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, mergers and acquisitions, strategic planning, and risk management.

(*) Recent and related managed health care experience, including medical claims and Medicaid managed care.

(*) Bachelor's degree required; Master's degree preferred.

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.

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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