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CVS Health · 8 hours ago

Executive Director, Network Operations - First Health

Hartford, CT

Full-time

Onsite

Director/Executive

$132K/yr - $303K/yr

15+ years exp

CVS Health is the nation’s leading health solutions company, dedicated to transforming health care. They are seeking an Executive Director to lead the First Health business, responsible for full P&L management, strategic planning, and overseeing a team to drive revenue growth and enhance network operations.

Health CareMedicalPharmaceuticalRetailSales

Responsibilities

Responsibility for full P&L including building of annual budgets, quarterly forecasting and strategic plans

Ensuring business strategies and tactics for achieving the financial commitments

Creating a vision and pathway to ensure long term revenue growth

Partnering with the Aetna network team to ensure network maintenance and development is integrated into the broader network roadmap

Building and maintaining an inclusive culture for the First Health team

Leading and ensuring network operations are maintained as required

Identifying new products and services they can extend the value of the First Health network

Leading the strategic development and expansion of the company's provider network by evaluating potential network providers, negotiating contracts, and establishing relationships with healthcare providers, hospitals, and clinics

Overseeing the negotiation, development, and management of contracts with network providers

Facilitating and tracking key performance indicators (KPIs) to assess provider performance, identify areas for improvement, and implement strategies to enhance network performance

Establishing positive and collaborative relationships with network providers, facilitating effective communication, and ensuring mutual understanding of expectations and contractual obligations

Ensuring stringent compliance with regulatory requirements and accreditation standards related to provider network management

Communicating with internal stakeholders, such as legal, finance, and operations, to ensure contracts are structured to meet quality, financial, and operational goals while complying with regulatory requirements

Implementing network strategies aligned with the organization's goals and market dynamics by evaluating market trends, competitive landscape, and patient needs to shape the network development strategy and optimize provider network composition

Managing operational aspects of the team, including budget, performance, and compliance, and implements workforce and succession plans to meet business needs

Overseeing performance expectations, provides guidance and feedback, and promotes a culture of continuous improvement and employee engagement

Qualification

Managed care experienceProvider contractingStrategic thinkingAnalytical skillsLeadership skillsCollaborationProblem solvingGrowth mindsetTeam managementCommunication skills

Required

15+ years of experience in managed care; leading and managing teams

Experience contracting with providers and hospital systems

Strong analytical skills including root cause analysis

Ability to think strategically

Adept at execution and delivery (planning, delivering, and supporting) skills

Adept at collaboration and teamwork

Mastery of problem solving and decision-making skills

Mastery of growth mindset (agility and developing yourself and others) skills

Skilled at collaborating and working across a matrixed organization

Expertise in market level management, cost drivers and levers, and knowledge of economic, regulatory and marketplace issues

Possess exceptional leadership skills and transformational experience with a proven track record of delivering results

Bachelor's degree required

Benefits

Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.

No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.

Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.