4062 Aetna Resources, LLC

The core responsibilities are not specified, but likely involve project coordination, stakeholder engagement, and process optimization. | The requirements are not detailed, but may include project management certifications and experience in related methodologies. | This job listing in [Unknown county] - PA has been recently added. Tallo will add a summary here for this job shortly.

Oversee project lifecycles, manage stakeholder relationships, and implement process improvements. | Requires 1+ years in health plans and benefits, 2+ years in project management, and skills in negotiation, conflict resolution, and specific tools like Salesforce. | At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day. Position Summary: Responsible for directing all aspects of customer benefit plan implementation of Self- funded New Business Clients. Partner with all key internal and external stakeholders to proactively identify and address critical implementation issues ensuring customer expectations are consistently satisfied or exceeded. Acts as a single point of contact for benefit plan implementation. Mediates and coordinates resolution of all project deliverables and implementation related tasks. Develops and executes implementation strategy consistent with customer expectations. Ensures strategy is administered in accordance with all performance guarantee arrangements. Engages team members to follow through on their responsibilities. Evaluates impact of customer requested exceptions and develops reasonable alternatives to satisfy Client needs while minimizing impact on systems and operations. Solicits and assesses internal and external customer feedback to enhance continuous quality improvement to self and overall implementation process. Required Qualifications: 1+ years Health Plans and Benefits experience 2+ years Project management and Client facing experience. Negotiation and conflict resolution skills across various levels of the organization. Ability to remain flexible yet focused during stressful situations. Attention to detail and accuracy while focusing on overall project deliverables. Ability to express complex concepts in a clear and concise manner. Highly organized and able to quickly prioritize multiple assignments with high quality results. Preferred Qualifications: Salesforce experience. Microsoft Teams, Excel, Outlook experience. Comprehensive understanding and strong association with Aetna organizations representing products, services, administration, operations and systems. Education: Associate's degree or Hight School diploma and equivalent experience. Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $46,988.00 - $122,400.00 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. 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: Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan. No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit https://jobs.cvshealth.com/us/en/benefits We anticipate the application window for this opening will close on: 12/19/2025 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. Our Work Experience is the combination of everything that's unique about us: our culture, our core values, our company meetings, our commitment to sustainability, our recognition programs, but most importantly, it's our people. Our employees are self-disciplined, hard working, curious, trustworthy, humble, and truthful. They make choices according to what is best for the team, they live for opportunities to collaborate and make a difference, and they make us the #1 Top Workplace in the area.

Lead network management and provider relations including contracting, performance monitoring, dispute resolution, and strategic network growth within the Keystone territory. | 10+ years in managed care with leadership experience, expertise in provider contracting and reimbursement, strong knowledge of value-based care and regulatory compliance, and ability to lead teams and drive strategic initiatives. | At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day. Position Summary 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 Keystone territory of Pennsylvania and West Virginia. 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. You'll make an impact by: Overseeing key network management contracting activities, including negotiating fee schedules, reimbursement rates, and contract terms and conditions. Controlling 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. Contributing 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. Managing the performance of network providers, including tracking key performance indicators, analyzing provider performance data, and implementing performance improvement initiatives. Conducting market analysis, assessing competitive landscapes, and making recommendations for network expansion strategies. Communicating findings to executive leadership and stakeholders, identifying opportunities for improvement and cost containment. Managing operational aspects of the team, subsequently implementing workforce and succession plans to meet business goals and objectives. Guiding management for individual performance evaluations aimed to provide critical feedback for skills development and depth of work area experience. Required 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: 10+ years of experience in managed care; leading and managing teams. Experience contracting with providers and hospital systems within the territory. Comprehensive understanding of hospital and physician financial issues and how to leverage technology to achieve quality and cost improvements for both payers and providers. In-depth knowledge of various reimbursement structures and payment methodologies for both hospitals and physicians. Comprehensive understanding of value-based strategies and population health management, and Aetna’s related strategic initiatives. Strong experience building and maintaining relationships with large hospitals/provider systems, integrated delivery systems and large physician groups. Understands the regulatory environment and ensures contractual compliance with federal and state requirements. Expertise in market level management, cost drivers and levers, and knowledge of economic, regulatory and marketplace issues. Possess exceptional leadership skills and transformational experience with a proven track record of delivering results.  High ability to drive new strategies or initiatives in highly cross-functional environments. Expertise with influencing and navigating a highly matrixed environment. Effectively lead and motivate teams to ensure high standards of performance and outcomes. Strong analytical and critical thinking skills. Focus on driving disciplined, fact-based decisions, and executing with discipline and urgency. Success in moving from current traditional strategies to new, modified approaches championing change. Person must reside within the market (PA or WV) or neighboring states with a willingness to travel within the market states. Education Bachelor's degree is 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: Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan. No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit https://jobs.cvshealth.com/us/en/benefits We anticipate the application window for this opening will close on: 01/04/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. Our Work Experience is the combination of everything that's unique about us: our culture, our core values, our company meetings, our commitment to sustainability, our recognition programs, but most importantly, it's our people. Our employees are self-disciplined, hard working, curious, trustworthy, humble, and truthful. They make choices according to what is best for the team, they live for opportunities to collaborate and make a difference, and they make us the #1 Top Workplace in the area.

Drive growth and strategic sales goals for Medicare Advantage External Distribution Partnerships, manage key projects, collaborate cross-functionally, and provide leadership to achieve sales targets. | 10-15 years in Marketing, Sales, and Insurance with Medicare expertise, 5-10 years in Medicare Advantage organizations, Medicare Advantage sales experience, proficiency in Microsoft Office, travel up to 25%, and a resident state producer license or ability to obtain it. | At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day. Position Summary Drive growth for Medicare Advantage External Distribution Partnerships by setting strategic sales goals, crafting winning strategies, and optimizing performance. Partner with senior leaders to deliver innovative solutions, streamline processes, and achieve measurable results. Act as Chief of Staff to the Executive Director of National External Distribution, ensuring alignment and execution of strategic priorities. What you will do Drive mission-critical, time-sensitive projects to successful completion with tight oversight and accountability. Implement core account management strategies and processes aligned with organizational goals and partner needs. Collaborate with cross-functional teams to understand partner requirements, develop solutions, and deliver value-added efficiencies. Present business reviews and performance reports to leadership, highlighting results and identifying improvement opportunities. Develop and enforce best practices in account management to enhance partner experience and operational excellence. Align projects, communications, and programs with annual objectives while ensuring financial efficiency and ROI. Provide strategic leadership across sales and related functions to drive actions and outcomes that achieve sales goals. Required Qualifications Bring 10–15 years of experience in Marketing, Sales, and Insurance, with required Medicare expertise. Offer 5–10 years of experience in Medicare Advantage organizations. Leverage 5+ years in Medicare Advantage sales in carrier or broker roles. Maintain a deep understanding of Medicare Advantage sales and marketing regulations. Demonstrate advanced proficiency in Microsoft Excel, PowerPoint, Word, and related tools. Travel up to 25% as needed to support business objectives. Hold a resident state producer license or obtain/renew within 6 months of hire. Preferred Qualifications Project Execution & Delivery – Planning, delivering, and supporting key initiatives Business Intelligence – Leveraging data for strategic decision-making Collaboration & Teamwork – Building strong cross-functional partnerships Problem Solving & Decision Making – Driving solutions and informed choices Growth Mindset – Adapting quickly and fostering continuous development Education Bachelor's degree preferred/specialized training/relevant professional qualification Pay Range The typical pay range for this role is: $100,000.00 - $265,914.00 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: Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan. No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit https://jobs.cvshealth.com/us/en/benefits We anticipate the application window for this opening will close on: 10/18/2025 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. Our Work Experience is the combination of everything that's unique about us: our culture, our core values, our company meetings, our commitment to sustainability, our recognition programs, but most importantly, it's our people. Our employees are self-disciplined, hard working, curious, trustworthy, humble, and truthful. They make choices according to what is best for the team, they live for opportunities to collaborate and make a difference, and they make us the #1 Top Workplace in the area.

Lead strategic growth initiatives and innovation across Aetna Pharmacy by driving business development, fostering partnerships, and guiding cross-functional teams to deliver measurable outcomes. | 8+ years in business development or innovation leadership, strong strategic and analytical skills, executive presence, and preferably healthcare or pharmacy industry experience. | At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day. **Strong preference for candidate to sit in EST** Position Summary The Lead Director of Business Development & Innovation will drive strategic growth across Aetna Pharmacy by identifying and executing high-impact initiatives that leverage CVS Health enterprise assets. This role blends external market development with internal innovation, fostering cross-functional collaboration and visionary leadership to advance strategic imperatives. Key Responsibilities Develop and communicate strategic business cases for new initiatives, ensuring clarity, alignment, and executive buy-in. Provide visionary leadership to matrixed teams, guiding multi-month, fast-paced projects with clear milestones and measurable outcomes. Identify and cultivate strategic partnerships, new markets, and revenue opportunities across the CVS Health enterprise. Engage with external partners and vendors to evaluate use cases for implementation and integration. Collaborate closely with the strategy and operations team to align initiatives with enterprise-wide strategic imperatives. Monitor industry trends, emerging technologies, and competitive landscapes to inform innovation and growth strategies. Champion a culture of innovation and agility within Aetna Pharmacy and across CVS Health. Required Qualifications 8+ years of experience in business development, innovation, strategy, or related fields. Proven success leading cross-functional initiatives in complex, matrixed environments. Strong analytical and strategic thinking skills with the ability to translate insights into actionable plans. Excellent communication and stakeholder engagement skills. Strategic foresight and market intelligence Executive presence and influence Preferred Qualifications Experience in healthcare, pharmacy, or related industries preferred. Innovation methodology (e.g., design thinking, agile). Partnership development and vendor management Education Bachelor's Degree preferred or a combination of education and work experience. Pay Range The typical pay range for this role is: $100,000.00 - $231,540.00 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: Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan. No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit https://jobs.cvshealth.com/us/en/benefits We anticipate the application window for this opening will close on: 10/25/2025 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. Our Work Experience is the combination of everything that's unique about us: our culture, our core values, our company meetings, our commitment to sustainability, our recognition programs, but most importantly, it's our people. Our employees are self-disciplined, hard working, curious, trustworthy, humble, and truthful. They make choices according to what is best for the team, they live for opportunities to collaborate and make a difference, and they make us the #1 Top Workplace in the area.