Executive Director, Network Management - Heartland Territory

Executive Director, Network Management

At Aetna, our health benefits business, we are committed to helping our members achieve their best health in an affordable, convenient, and comprehensive manner. Combining the assets of our health insurance products and services with CVS Health's unrivaled presence in local communities and their pharmacy benefits management capabilities, we're joining members on their path to better health and transforming the health care landscape in new and exciting ways every day.

Aetna is recruiting for an Executive Director, Network Management who provides strategic leadership and oversight for network management and provider relations within the Heartland market. This leader will develop and implement network strategies, manage provider contracts and negotiations, monitor provider performance metrics, lead dispute resolution processes, and collaborate with key stakeholders to drive network growth and ensure high-quality provider relationships.

Major Responsibilities

• Oversees key Network Management contracting activities, including negotiating fee schedules, reimbursement rates, and contract terms and conditions.
• Controls the development and expansion of the company's provider network by evaluating potential network providers, negotiating contracts, and establishing relationships with healthcare providers to ensure a comprehensive and high-quality network.
• Contributes to optimizing the network's performance and effectiveness by analyzing network data, utilization patterns, and market trends to identify opportunities for network enhancements, cost savings, and improved access to care.
• Manages the performance of network providers, including tracking key performance indicators, analyzing provider performance data, and implementing performance improvement initiatives.
• Conducts market analysis, assesses competitive landscapes, and makes recommendations for network expansion strategies.
• Communicates findings to executive leadership and stakeholders, identifying opportunities for improvement and cost containment.
• Manages operational aspects of the team, subsequently implementing workforce and succession plans to meet business goals and objectives.
• Guides management for individual performance evaluations aimed to provide critical feedback for skills development and depth of work area experience.

Required Qualifications

Education

Pay Range

The typical pay range for this role is : $131,500.00 - $303,195.00

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. This position also includes an award target in the company's equity award program.

Great benefits for great people

We take pride in our comprehensive and competitive mix of pay and benefits investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include :