Aetna Chief Executive Officer, Aetna Better Health of Florida in Sunrise, Florida
Req ID: 51271BR
This full-time position is the top executive position for Aetna Better Health of FL Medicaid Plan and is the lead contact for all communication between the State Medicaid Department, Agency for Health Care Administration (AHCA) and FL Healthy Kids. The Chief Executive Officer (CEO) has accountability and authority for administration and implementation of all contract requirements, including ownership of profit and loss: meeting revenue, membership and operating income plans. The CEO is responsible for the daily conduct, compliance and operations of the FL Medicaid, LTC and Florida Healthy Kids plans. The primary office location is Sunrise FL; other offices are located in Doral, Tampa, Tallahassee, Orlando, and Boynton Beach, in addition to a future Medicaid office location in Plantation. Travel to all offices is expected, as well as travel to meet and engage with key stakeholders including, but not limited to Hospitals, Providers and FQHCs within the state of FL. There will be some minimal travel required outside of FL, to the corporate offices in Phoenix Arizona and other East Region locations for Management Meetings.
Establishes and maintains an effective management process and system for reviewing/assessing the State contract, for Compliance, Reporting and achieving State goals and objectives. CEO will insure the State relationship is a trusting, effective relationship, offering support and actions to improve services to the State agency. Will be 100 percent assigned to the contract, with overall responsibility for the administration of the contract and daily operations, including overseeing the budget and accounting system. Communicates State agency requirements for program implementations; coordinates with internal resources to implement contract requirements; communicates ongoing implementation progress with representatives of the State and regulatory agencies. Assists representatives of the State agency, as requested, regarding issues related to all administrative services. Achieves and maintains full understanding of the contract/requirements, programs and policies, including service scope, special service features, history of service issues, and contact with State representatives. Implements contract requirements. Responsible for successful implementation of all of the ITN commitments, VBS goals, Quality and Member outcomes. Oversees the day-to-day operations of the staff in achieving goals set forth to meet State goals and objectives. Some staff are direct while others are dotted line. Must be able to manage in a matrix environment with Shared Services partners. Manages operations, meets/exceed goals within the approved budget. Participates and engages in all State level meetings, this role is the face of the MCO Plan and develops and oversees all State, Community and Provider relationships. Macro-environmental view of competitive landscape, regulatory and legislative impact to the plan. Develops safety net provider relations, provider services, community involvement and promotes awareness of the plan. Strategic planning and development of operating plan to support business operations. Works with management team to develop quality improvement and cost savings initiatives. Motivates and leads a high-performance management team, recruiting, training, developing mentoring and retaining experienced staff.
Minimum of 10 years progressive management experience in managed care or a health care related position, with demonstrated experience and results in financial management, operations, medical delivery and/or managed care systems. Effective technical skills regarding health plan administration, medical management cost drivers/trends, actuarial and underwriting.
The highest level of education desired for candidates in this position is a Bachelor's degree or equivalent experience.
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ADDITIONAL JOB INFORMATION
Bachelor's degree or equivalent experience, Master's degree preferred. - Effective and advanced oral and written communication skills required; must have senior level experience with Medicaid programs and regulations, a professional image, and the ability to interface with State and community leaders. - Ability to lead and influence, motivate and educate staff. Ability to represent organization and company in external meetings and or healthcare venues. - Ability to manage multiple projects with tight deadlines - Effective organizational skills - Proficiency with Microsoft Office Suite applications. Are you ready to join a company that is changing the face of health care across the nation? Aetna Better Health of FL is looking for people like you who value excellence, integrity, caring and innovation. As an employee, youll join a team dedicated to improving the lives of the most vulnerable in our population. Our vision incorporates community-based health care that works. We value diversity. Align your career goals with Aetna Better Health of FL, and we will support you all the way.
Job Function: Management