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We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. At Aetna, a CVS Health company, we are committed to helping our members achieve their best health in an affordable, convenient, and comprehensive manner. By combining our health insurance products and services with CVS Health’s strong local presence and pharmacy benefits management capabilities, we partner with members on their path to better health while transforming the health care landscape. Aetna is recruiting an Associate Vice President (AVP), Network Government Services to provide strategic and operational leadership for network performance, actuarial partnership, adequacy, and compliance across Medicare and Medicaid. This role leads a dedicated team and serves as a critical connector between network strategy, bid development, regulatory filings, and market execution.
Job Responsibility:
Lead and develop a team responsible for government network actuarial support, adequacy, and compliance
Partner with government business leaders to support affordability, bid competitiveness, and where appropriate membership growth
Influence across a highly matrixed organization
Medicare actuarial support: Focus on network curation, provider‑specific financial impacts of policy and contracting decisions, and strategic bid guidance
Medicaid actuarial support: Analyze cost and utilization outliers, support de‑novo market opportunities, and evaluate network competitiveness
Oversee network adequacy analysis and reporting for Medicare, Medicaid, and Commercial programs
Provide operational leadership for Medicare network compliance
Translate complex, and at times conflicting, data into clear recommendations
Requirements:
10+ years of experience in the health insurance industry
Direct experience with Medicare and Medicaid network development, management, and performance oversight
Demonstrated people leadership experience with responsibility for developing and managing teams
Proven experience operating in a highly matrixed environment with actuarial, network, operations, clinical, and government program leaders
Strong analytical, problem‑solving, and executive communication skills
Nice to have:
Experience partnering closely with actuarial teams
actuarial exam progress or certification is a plus but not required
Experience supporting Medicare and Medicaid bids, regulatory filings, or rate development
Background in network adequacy analytics, compliance, or regulatory reporting
Demonstrated commitment to a growth mindset, including talent development, agility, and continuous learning
What we offer:
Affordable medical plan options
401(k) plan (including matching company contributions)
Employee stock purchase plan
No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching