Executive Director, Head of First Health

Executive Director, First Health

First Health is a large, national Preferred Provider Organization (PPO) network owned by Aetna, which provides members access to discounted healthcare services from a broad network of doctors, hospitals, and other providers across the United States. While it is owned by Aetna, First Health functions as a separate subsidiary, specializing in connecting its payer clients and their members to a nationwide network of doctors and facilities at negotiated rates to help manage costs and improve access to care.

Aetna is seeking an Executive Director to lead the First Health business with full P&L responsibility. This role encompasses the development of annual budgets, quarterly forecasts, and long-term strategic planning. The Executive Director will oversee network management and provider relations, while also crafting a forward-looking vision to drive sustained revenue growth. This leader will manage a team of 70 professionals and be accountable for delivering $100 million in annual revenue.

Major 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.

Qualifications

The candidate will have a strong work ethic, be a self-starter, and be able to be highly productive in a dynamic, collaborative environment. This position offers broad exposure to all aspects of the company's business, as well as significant interaction with all the business leaders. The candidate will be expected to have the following key attributes :

Education

Bachelor's degree required.

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.

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

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 :

We anticipate the application window for this opening will close on : 10 / 04 / 2025

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.