Executive Director, Chief Operations Officer - Aetna Better Health of Maryland
Core
Strategic leader overseeing all operational activities for a state-wide Medicaid managed care plan, including claims, provider services, medical management, and compliance.
Role type
Executive Director / Chief Operations Officer (COO)
Builds
Operational excellence and business performance for a Medicaid managed care organization
Domain
Healthcare / Medicaid Managed Care / Public Health
Deliverable
production ML models | product features | dashboards & analysis | research | client delivery | infrastructure | physical/clinical work
Required skills
Medicaid program management, executive leadership, financial management (P&L), provider relations and contracting, regulatory compliance, strategic planning, stakeholder management, team development, business process optimization, negotiation
Preferred skills
Knowledge of Maryland HealthChoice Program, knowledge of Code of Maryland Regulations (COMAR), experience with Mergers and Acquisitions
Technologies
Claims systems, Encounter data management, Call center operations platforms
Responsibilities
Partner with CEO to drive growth and operational excellence; oversee financial management including budget and P&L; lead provider operations including credentialing and network development; ensure compliance with state contracts and regulations; advocate with regulators and policymakers; support community-based programs addressing Social Determinants of Health
Seniority
Executive, C-suite level
