Chief Health Services Officer - Aetna Better Health of IL (Remote)

About the position Responsibilities • Maintain operational excellence through matrixed leadership and oversight of centralized medical management functions. • Serve as the subject matter expert in medical management operations, including Utilization Management, Care Management, and Quality integration. • Ensure the organization understands Illinois' needs, compliance benchmarks, and timelines. • Oversee the analysis, management, execution, and staffing for all health services operations impacting the health plan. • Provide oversight of the Quality team's activities to ensure optimal performance with HEDIS and accreditations. • Act as the single point of contact on health services operations between the health plan and regulators. • Represent the health plan as the health services SME for all Plan-specific RFP activity. • Lead and partner with the COO on clinical program vendor implementations. • Capture and communicate internal clinical initiatives to ensure a cohesive clinical strategy. • Identify compliance processes needed to meet Medicaid standards and ensure timely quality reviews of reports. • Present complex concepts to various levels of leadership within the organization. • Serve as point of contact for all health services operations and meet with external stakeholders as needed. Requirements • 10+ years of experience in medical management leadership roles including leadership within managed care organizations. • 5+ years of Medicaid experience, preferably in the State of Illinois. • Experience with data analytics reporting and analysis used to help serve managed care populations. • Experience presenting executive level presentations to various internal and external audiences. • Strong influencing skills to effectively work across a wide range of senior stakeholders to drive alignment and results. • Extensive experience leading cross-functional initiatives and driving innovation. • Experience working with varying levels of contacts, including executive leadership and external state officials. • Demonstrated success in collaboration, teamwork, and execution across multiple departments to deliver results. • Strong decision-making, analytical and organizational skills. • Ability to develop and execute strategic and tactical business plans. • Ability to exercise sound business judgment to achieve proper balance between objectives and stakeholder engagement. • Demonstrate a commitment to diversity, equity, and inclusion through continuous development and modeling inclusive behaviors. Nice-to-haves • Registered Nurse, preferably in the state of IL. • Illinois state resident. • Interaction with the state regarding Medicaid programs, contract requirements, reporting, and deliverables. Benefits • Full range of medical, dental, and vision benefits. • 401(k) retirement savings plan. • Employee Stock Purchase Plan available for eligible employees. • Fully-paid term life insurance plan for eligible employees. • Short-term and long-term disability benefits. • Numerous well-being programs and education assistance. • Free development courses. • CVS store discount and discount programs with participating partners. • Paid Time Off (PTO) or vacation pay, as well as paid holidays throughout the calendar year. Apply tot his job Apply To this Job