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Position Summary

Aetna is recruiting for an Executive Director, IFP Market Lead to support the Individual & Family Plans business, a growing business that began due to the 2010 Affordable Care Act, in the West region (TX, AZ, UT, CA, NV). This fully accountable leader will be charged with delivering sustainable profitable growth for Aetna’s Individual Exchange business in the respective geography. The Regional Market Lead is directly accountable for defining the market strategy for all states and rating areas within the region, with an understanding of competitive positioning, relative performance against competitors, and local healthcare ecosystem dynamics.  This segment leader will coordinate with segment leadership to establish and achieve financial goals and lead the governance and coordination with functions supporting those goals. This leader is accountable for the performance of the business with respect to membership, revenue, gross profit and selling expenses, but must work in collaboration with matrix partners across the organization on delivery of those goals.  They must also collaboratively work with other segments to ensure optimized IFP performance while accommodating occasionally competing enterprise needs. to achieve.

You'll make an impact by:

• Providing cross-functional leadership of shared-service regional team to drive local focus on financial targets, identification and prioritization of improvements, and delivery.

• Managing relationships with key internal and external stakeholders including regional leads from other segments, functions such as Network and Revenue Integrity, regulators, providers, and distribution partners.

• Responsibility for managing cost structure, HEDIS, and Revenue Integrity efforts.

• Influencing Individual sales, operations, contracts, provider relations, network development, utilization management, quality improvement and coordinates and monitors functional integration of these areas in cooperation with corporate departments to achieve planned business results.

• Directing all departments and teams in the development, implementation and maintenance of policies and procedures to ensure compliance with State and Federal regulatory requirements.

• Responsibility for the plan performance related to all required Federal audits.

• Monitoring the budget in assigned function areas and takes corrective action.

• Coaching, mentoring, and managing performance of team members. Driving talent development and actively building bench talent. 

• Creating a customer focused culture and collaborates across the organization to ensure internal and external constituent needs are met.

• Serving as an Ambassador for increasing Individual Exchange market knowledge.

• Promoting cultural awareness and sensitivity that matching the needs of communities served.

• Supporting CVS Health in attracting, retaining, and engaging a diverse and inclusive consumer-centric workforce that delivers on our purpose and reflects the communities in which we work, live, and serve.

Required Qualifications

The candidate will have a strong work ethic, be a self-starter, and be able to be highly productive in a dynamic, collaborative environment. This position offers broad exposure to all aspects of the company’s business, as well as significant interaction with all the business leaders. The candidate will be expected to have the following key attributes:

• 7-10 years of experience in business development, direct sales, or client management leadership roles.

• 3-5 years of solid Individual Exchange experience.

• Knowledge of insurance regulatory and contractual requirements.

• Proven team leadership experience - leadership skills to build high-performing teams, manage and develop talent, influence, and impact a broad set of stakeholders, engage, and inspire others, and lead by example.

• Ability to develop and execute strategy.

• P&L expertise with a strong financial, bottom-line focus.

• Demonstrated experience exhibiting strong business judgement skills.

• Ability to understand the target audiences, needs and sales management.

• Strong consultative and business problem solving skills.

• Ability to effectively interact with a diverse workforce and cross functional groups. Experience working in a matrixed environment.

• Ability to work effectively with multiple internal and external clients.

• Knowledge of value-based agreements.

• This is a remote position and it is preferred that the leader resides within the regional states. There is 25 - 30% travel required for this role.

• Demonstrate a commitment to diversity, equity, and inclusion through continuous development, modeling inclusive behaviors, and proactively managing bias.

Preferred Qualifications

• Expertise in Managed Care and IFP/ Marketplace business lines.

• Knowledge of local markets in geographical areas – West (TX, AZ, UT, CA, NV).

• Previous experience working for a large, national carrier.

Education

Bachelor's Degree or equivalent work experience is required.

Pay Range

The typical pay range for this role is:

$131,500.00 - $303,195.00

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls.  The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors.  This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.  This position also includes an award target in the company’s equity award program. 
 
In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities.  The Company offers a full range of medical, dental, and vision benefits.  Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees.  The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners.  As for time off, Company employees enjoy Paid Time Off (“PTO”) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies. 
 
For more detailed information on available benefits, please visit Benefits | CVS Health

We anticipate the application window for this opening will close on: 12/20/2024

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.