AVP, Business Operations - Medical Policy & Program Solutions

$157,800 - $363,936/Yr

CVS Health - Blue Bell, PA

Full-time - Senior

Remote - Blue Bell, PA

Health and Personal Care Retailers

About the position

The AVP, Business Operations at Aetna is responsible for developing Medical Policy & Program Solutions (MPPS) and executing strategic and operational objectives across Commercial, Medicare, and Medicaid lines of business. This role focuses on achieving financial and performance targets while managing vendor relationships and ensuring compliance with contract guidelines. The position emphasizes operational efficiencies and cost savings, fostering collaboration with internal and external partners, and leading high-performing teams to meet organizational goals.

Responsibilities

• Lead the strategy and drive operational efficiencies across Commercial, Medicare, and Medicaid lines of business.
• Manage the primary relationship with key vendors and oversee the contractual process.
• Execute short and long term strategic and operational objectives for Commercial, Medicare, and Medicaid lines of business.
• Collaborate with executive leadership and serve as the primary representative of the business in vendor meetings.
• Achieve cost savings through successful implementation and management of Scoreable Action Items (SAIs).
• Develop and maintain collaborative relationships with internal and external partners.
• Promote high standards of operational practice through policies and procedures.
• Implement and monitor operational processes and workflows using industry best practices.
• Lead recruitment and develop staffing models that meet business needs.
• Motivate and manage high-performing teams to achieve organizational goals.
• Foster a culture of professional development and operational excellence.
• Support diversity, equity, and inclusion initiatives within the workforce.

Requirements

• 15+ years of experience leading complex teams in the healthcare system.
• Strong interpersonal and communication skills for effective messaging to stakeholders.
• Strong business and financial acumen with a history of achieving results.
• Expertise in operationalizing vendor solutions to complex issues.
• Ability to develop innovative operational changes and demonstrate executive presence.
• Ability to work in a hybrid model and travel up to 20%.

Nice-to-haves

• Experience in medical management, claims, and provider networks.
• Demonstrated commitment to diversity, equity, and inclusion.

Benefits

• Full range of medical, dental, and vision benefits.
• 401(k) retirement savings plan with company match.
• Employee Stock Purchase Plan available.
• Fully-paid term life insurance plan.
• Short-term and long-term disability benefits.
• Well-being programs and education assistance.
• Free development courses.
• CVS store discount and partner discount programs.
• Paid Time Off (PTO) and paid holidays.