Phoenix, Arizona

Job Description
The Arizona-Mountain Chief Medicare Officer (CMO) has P&L accountability for the IVL/DSNP products in the AZ-MTN market (AZ, NV, UT, MT, WY), driving sales and customer experience strategies in market, as well as Go-To Market planning and execution. The CMO is the leader for market performance, cost structure, and local execution of STARs, compliance, and revenue integrity efforts for all Medicare Advantage products (inclusive of collaborating with the Employer Group team for EGWP products) to achieve sales and client satisfaction goals in collaboration with corporate teams. The AZ-MTN CMO will drive local product strategy and local market intelligence collection, be responsible for achieving target market position and market share growth and manage cost structure position in collaboration with national Medicare segment leadership, the market president, and related teams. The role reports to the President, Arizona & Northwest-Mountain Markets, with a dotted line to VP, Medicare Performance Management and Business Enablement, and is a key part of the AZ & NW-MTN market leadership team.

Essential Functions:
 Responsible for the overall financial performance and achievement of budget for Medicare plans within the market
 Creates and executes a sustainable and profitable growth strategy
 Directs managers and/or directors of specific functional areas as assigned, which may include operations, sales, marketing, provider relations, network development, utilization management, STARS/HEDIS quality improvement, and revenue integrity efforts; coordinates and monitors functional integration of these areas in cooperation with corporate departments to achieve planned business results
 Directs all departments in the development, implementation, and maintenance of policies and procedures to ensure compliance with the State and Federal regulatory requirements
 Responsible for local health plan performance related to all required State and Federal audits for Medicare business
 Responsible for management and organization of local market health plan activities as it relates to the Medicare business
 Monitors budget in assigned function areas and takes corrective action when needed
 Recruits, develops, and motivates staff through coaching, mentoring, and managing performance of team members; drives talent development and actively builds bench
 Creates customer-focused culture and collaborates across the organization to meet internal and external stakeholder needs
 Accountable for working with corporate Medicare functional areas for monthly results, bid execution, and other initiatives

Required Qualifications
• Responsible for the overall financial performance and achievement of budget for Medicare plans within the market
• Creates and executes a sustainable and profitable growth strategy
• Directs managers and/or directors of specific functional areas as assigned, which may include operations, sales, marketing, provider relations, network development, utilization management, STARS/HEDIS quality improvement, and revenue integrity efforts; coordinates and monitors functional integration of these areas in cooperation with corporate departments to achieve planned business results
• Directs all departments in the development, implementation, and maintenance of policies and procedures to ensure compliance with the State and Federal regulatory requirements
• Responsible for local health plan performance related to all required State and Federal audits for Medicare business
• Responsible for management and organization of local market health plan activities as it relates to the Medicare business
• Monitors budget in assigned function areas and takes corrective action when needed
• Recruits, develops, and motivates staff through coaching, mentoring, and managing performance of team members; drives talent development and actively builds bench
• Creates customer-focused culture and collaborates across the organization to meet internal and external stakeholder needs
• Accountable for working with corporate Medicare functional areas for monthly results, bid execution, and other initiatives

COVID Requirements
COVID-19 Vaccination Requirement
CVS Health requires its Colleagues in certain positions to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, pregnancy, or religious belief that prevents them from being vaccinated.
  • If you are vaccinated, you are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status within the first 30 days of your employment. For the two COVID-19 shot regimen, you will be required to provide proof of your second COVID-19 shot within the first 60 days of your employment. Failure to provide timely proof of your COVID-19 vaccination status will result in the termination of your employment with CVS Health.
  • If you are unable to be fully vaccinated due to disability, medical condition, pregnancy, or religious belief, you will be required to apply for a reasonable accommodation within the first 30 days of your employment in order to remain employed with CVS Health. As a part of this process, you will be required to provide information or documentation about the reason you cannot be vaccinated. If your request for an accommodation is not approved, then your employment may be terminated.


Preferred Qualifications
• Deep knowledge of local markets in the States of AZ, NV, and/or UT, preferably with respect to Medicare dynamics
• Previous experience working for a large, national health insurance carrier
• Previous experience with Dual Special Needs Plans
• Background in health care industry and/or insurance
• Knowledge of insurance regulatory and contractual requirements
• Knowledge of current health care marketplace dynamics and Aetna’s position in the market
• Knowledge of Aetna’s operations and marketing processes and strategies

Education
• BA/BS degree preferred

Business Overview
At Aetna, a CVS Health company, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.


We are committed to maintaining a diverse and inclusive workplace. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, gender, gender identity, age, disability or protected veteran status. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities. See Job Description

Phoenix, Arizona

Continue serving and work with a purpose

As a CVS Health colleague, you'll find career opportunities across the organization and at every stage of your career. More important, your work will have an impactful purpose on someone's life, including your own. Learn more about how you can continue serving on your next mission at CVS Health.

Careers for Veterans and Military Spouses

 

"The military has an ethos that is grounded in purpose-driven service that’s bigger than the individual. The same holds true for us at CVS Health. You can talk to colleagues in any part of our business and they will be able to articulate our company’s purpose. Working here provides an opportunity for service members and military spouses to continue to serve, just in a civvies."

Similar jobs