Job Description
Job Description
Reporting directly to the SVP, Chief Medical Officer Aetna, this position as VP, Chief Medical Officer Provider Network - Aetna is the senior Medical Affairs leader integrating and supporting Network and Provider Relations.
Aetna Medical Affairs primary support for Network and Provider Relations, to provide clinical input, integration, and collaboration for:
* Development and implementation of Network of the Future and other key priority Network and Provider Relations strategies that improve health outcomes, decrease cost, enhance the provider experience, enrich the member experience, and promote health equity
* Communication with partner providers through face-to-face, virtual, telephonic, and written interactions
* Conflict and dispute resolution with partner providers
* VBS contract development and negotiations for all lines of business
* Provider Credentialing concerns
* Clinical - Network Joint Operating Committee as co-lead
Aetna Medical Affairs lead for provider-related operational efficiency projects, such as:
* Preferred Provider Program analysis and implementation
* Medical Management automation projects
* Narrow Network selection and partnerships
* Virtual Care strategy and network support
Clinical Thought Leadership related to Network strategy:
* Contribute to Physician Relations Strategy with internal clinical stakeholders and external leaders to support future initiatives, investments and anticipated impacts to health care sector
* Provide education for CVS medical directors and network partners on issues in medical management and Value-Based Solutions
* Evaluation and recommendations for cross-enterprise innovative programs that would impact Network providers and provider relations
Aetna Medical Affairs representative to advance cross-enterprise CVS goals and objectives related to network and provider relations, including:
* CVS Provider Experience initiatives
* CVS Integrated Network development
Travel requirements: 10% - 25% domestic travel
Required Qualifications
* 15+ years of provider network related work experience
* Proven and progressive experience in medical management, value-based solutions, strategic thought leadership, and provider dispute resolution
* Demonstrated leadership experience/role in a large healthcare corporation or system.
* Demonstrated record of effectively leading programs that advance improved clinical outcomes.
* Strong interpersonal skills that reflect and build trust and credibility
* Ability to organize and integrate strategies, priorities and deadlines.
* Demonstrated ability to work effectively and collaboratively in a fast-paced environment. Works independently and works well with ambiguity.
* Demonstrated experience as a leader who clearly communicates with and engages leaders, clinical community and team members in establishing a culture of transparency, trust and continual improvement.
COVID Requirements
COVID-19 Vaccination Requirement
CVS Health requires certain colleagues 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, religious belief, or other legally recognized reasons that prevents them from being 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 or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.
Preferred Qualifications
N/A
Education
* Medical Degree and licensure required
Business Overview
Bring your heart to CVS Health
Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at its center - our purpose sends a personal message that how we deliver our services is just as important as what we deliver.
Our Heart At Work Behaviors support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.
We strive to promote and sustain a culture of diversity, inclusion and belonging every day.
CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.
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