Aetna Bus Proj Program Sr Mgr in Hartford, Connecticut

Req ID: 45989BR

POSITION SUMMARY

This position will act as the Clinical Services Project Management lead with Provider Solutions Operations and to define business requirements (to support current functionality and day 1 enhancements) and conduct testing for the new clinical platform. This role will be responsible for communicating status to the Head of Clinical Services, clinical leaders and our segment partners to ensure the organization understands the system needs and desired enhancements to support clinical vision 2020.

Fundamental Components:

This position will also influence system work needed to deliver on our commitments to our customers including providers, plan sponsors and individual consumers. Responsibilities include:

Project management lead for Clinical Services working with the Provider Solution Operations team, Utilization Management team and IT to develop business requirements and conduct testing for the new clinical platform build.

Coordinate with UM operations leads to modify processes and workflows to support the new clinical platform.

Responsible for representing all clinical areas within Clinical Services on the clinical platform build to ensure MD, nurse, pre-certification, Clinical Claim Review and Medical Policy needs are met with business requirements.

Communicate project status to Head of Clinical Services and key segment partners; responsible for ongoing executive level reporting.

Represent Clinical Services on all clinical platform workgroups and committee meetings.

Project management lead for Clinical Services coordinating the membership migration to the new clinical platform in 2018.

BACKGROUND/EXPERIENCE desired:

10+ years managed care / health insurance industry experience. Multiple years proven leadership experience setting strategic direction and influencing change that resulted in quantifiable positive outcomes. Proven track record managing complex projects and or programs that resulted in cost savings. Project management experience. Demonstrated negotiation skills.

EDUCATION

The highest level of education desired for candidates in this position is a Bachelor's degree or equivalent experience.

ADDITIONAL JOB INFORMATION

Required skills:

Strong Project Management

Ability to successfully collaborate with key business partners, clinical colleagues across the enterprise and IT

Ability to communicate with impact

ATV/NavCare knowledge preferred

Aetna is about more than just doing a job. This is our opportunity to re-shape healthcare for America and across the globe. We are developing solutions to improve the quality and affordability of healthcare. What we do will benefit generations to come.

We care about each other, our customers and our communities. We are inspired to make a difference, and we are committed to integrity and excellence.

Together we will empower people to live healthier lives.

Aetna is an equal opportunity & affirmative action employer. All qualified applicants will receive consideration for employment regardless of personal characteristics or status. We take affirmative action to recruit, select and develop women, people of color, veterans and individuals with disabilities.

We are a company built on excellence. We have a culture that values growth, achievement and diversity and a workplace where your voice can be heard.

Benefit eligibility may vary by position. Click here to review the benefits associated with this position.

Aetna takes our candidate's data privacy seriously. At no time will any Aetna recruiter or employee request any financial or personal information (Social Security Number, Credit card information for direct deposit, etc.) from you via e-mail. Any requests for information will be discussed prior and will be conducted through a secure website provided by the recruiter. Should you be asked for such information, please notify us immediately.

Job Function: Management