Full-Time

Chief Health Services Officer

Aetna Better Health of IL

Confirmed live in the last 24 hours

CVS Pharmacy

CVS Pharmacy

10,001+ employees

Retail pharmacy and healthcare services provider

Healthcare
Consumer Goods

Compensation Overview

$100k - $231.5kAnnually

+ Bonus + Commission + Equity Award Program

Expert

Company Historically Provides H1B Sponsorship

Remote in USA

Fully remote; Illinois resident preferred.

Category
Healthcare Administration & Support
Medical, Clinical & Veterinary
Required Skills
Data Analysis
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, department leadership, capability enablers and external state officials.
  • Demonstrated success in the areas of 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, modeling inclusive behaviors, and proactively managing bias
Responsibilities
  • Ensuring the organization understands Illinois' needs, compliance benchmarks and timelines. You will work closely with the organization to ensure the organization delivers on these needs. Representing the health plan to shared services and the enterprise broadly.
  • Overseeing the analysis, management, execution and staffing for all health services operations impacting the health plan.
  • Overseeing the plan to a detailed and supportive oversight of the activities of the Quality team to ensure maximal performance with HEDIS and accreditations.
  • Serving as the SPOC on health services operations (CM, UM, all related programs) between the health plan and regulators. This role represents the health plan as the health services SME for all external and regulatory stakeholders.
  • Representing the health plan as the health services SME for all Plan-specific RFP activity.
  • Leading and partnering with the COO clinical program vendor implementations and maintaining an oversight relationship with all external clinical program stakeholders.
  • Capturing and communicating to the health plan leaders all internal (AMA, Aetna, CVS) clinical initiatives to ensure the Plan maintains a cohesive clinical strategy appropriate to our market competitiveness and growth goals.
  • Identifying the compliance processes needed to ensure we meet all standards in our Medicaid, such as monitoring report owners and the timely quality review of these reports and works with COO and Compliance to ensure overall compliance of processes.
  • Presenting complex concepts to various levels of leadership within the organization.
  • Serving as point of contact for all health services operations, meet with external stakeholders, such as providers, as needed.
  • Supporting CVS Health in attracting, retaining, and engaging a diverse and inclusive consumer-centric workforce that delivers on our purpose and reflects the communities in which we work, live, and serve.

CVS Health operates a large network of retail pharmacies and walk-in medical clinics across the United States, providing a variety of health-related products and services. Their offerings include prescription medications, over-the-counter health products, beauty items, and general merchandise. CVS Health also functions as a pharmacy benefits manager, serving over 75 million plan members, and has a senior pharmacy care business that assists more than one million patients each year. This integrated approach allows CVS Health to deliver affordable health management solutions, improving access to quality care and health outcomes while aiming to reduce overall healthcare costs. Unlike many competitors, CVS Health combines retail pharmacy services with clinical care and pharmacy benefits management, making it a significant player in the healthcare sector with a goal of helping individuals achieve better health.

Company Stage

Debt Financing

Total Funding

N/A

Headquarters

Woonsocket, Rhode Island

Founded

1963

Growth & Insights
Headcount

6 month growth

0%

1 year growth

0%

2 year growth

0%
Simplify Jobs

Simplify's Take

What believers are saying

  • Expansion of at-home health testing aligns with consumer-driven healthcare trends.
  • Simplified digital scheduling for vaccinations enhances customer convenience and service efficiency.
  • Growing market for over-the-counter hearing aids presents new product opportunities for CVS.

What critics are saying

  • DOJ's civil complaint poses legal and financial risks for CVS.
  • Allegations of violating opioid regulations could damage CVS's reputation and consumer trust.
  • Competition from Walmart and Amazon in at-home health tests may impact CVS's market share.

What makes CVS Pharmacy unique

  • CVS offers a wide range of health services, including walk-in clinics and vaccinations.
  • The company collaborates with local police for drug collection, enhancing community engagement.
  • CVS maintains free cash-back services, differentiating from competitors charging fees.

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