Vice President & Chief Operating Officer, Medical Affairs - Aetna

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Position Summary

Aetna is seeking to hire a VP
,,
Chief Operating Officer for Medical Affairs
with deep experience in enterprise‑level clinical operations. Reporting directly to Aetna’s Senior Vice President & Chief Medical Officer, this senior executive will serve as the primary operational leader overseeing all core Aetna Medical Affairs functions, including utilization management, appeals, care management, care model design, clinical pathways, Network/Provider Engagement, and clinical enablement programs.

The VP, COO for Medical Affairs will act as a
strategic partner
to the
CMO‑VPs for Commercial, Medicare, a
nd
Medicaid as well as to the
VP of Utilization Management
, ensuring alignment between line‑of‑business strategies and Medical Affairs operations. This leader will also serve as the
principal operational interface with ACS and Network leadership, ensuring cross‑functional integration, operational readiness, and consistent national execution.

The successful candidate will bring an enterprise mindset and the ability to build a unified operating model across Aetna Medical Affairs
. This includes developing consistent national processes, ensuring compliance and performance, advancing technology‑enabled operations, and driving scalable, measurable improvements in quality, efficiency, and member and provider experience.

Major Responsibilities

• Serves as a key strategic operational advisor to the Aetna CMO VPs for Commercial, Medicare, Medicaid, and Utilization Management, across both physical and behavioral health, ensuring Medical Affairs operations support and enabling each line of business’s clinical and financial objectives.
• Acts as the primary operational liaison with ACS and Network leadership, driving enterprise-wide alignment on clinical operations, policy, workforce strategy, and operating standards.

• Leads development and continuous evolution of the
  enterprise A
  etna
  Medical Affairs operating model
  , spanning utilization management, appeals, care management, care model design, clinical pathways, network alignment, and quality programs.
• Serves as the Med Affairs lead for Aetna enterprise-wide operating plans
  , integrating efforts across ACS, Network, Technology, Analytics, and business‑unit clinical leadership.
• Establishes and maintains consistent national operating standards, governance structures and documentation, workflows, and performance expectations across all Aetna Medical Affairs programs.

• Designs and oversees dashboards, KPIs, and scorecards
  for all Aetna Medical Affairs functions, using insights to optimize and drive performance.
• Leads the strategy and execution of enterprise reporting, ensuring standardized, accurate, and actionable data for leadership and key stakeholders.
• Establishes performance review structures, operational early‑warning systems, and transparent reporting mechanisms for Aetna Medical Affairs leadership and line of business partners.
• Partners closely with analytics and technology teams to leverage data, insights, and automation to improve outcomes, efficiency clinical decision making.

• Provides oversight for Aetna Medical Affairs workforce management strategy, including capacity planning, staffing models, productivity optimization, and resource allocation across Medical Affairs.
• Leads integrated workforce planning to ensure alignment with business demand, regulatory requirements, and performance expectations.
• Drives operational excellence through continuous process improvement, workload balancing, and optimization of clinician and operational team performance.