Aetna Sr Practice Transformation Consultant (Pediatrics) in Phoenix, Arizona

Req ID: 45744BR


The CMS Transforming Clinical Practice Initiative (TCPI) is assisting 140,000 clinicians nationwide in improving the effectiveness and efficiency of care by providing technical assistance for integrating quality improvement and by building on and spreading existing practice transformation tools, published literature, and technical assistance programs. As an awardee of this grant, AZ HealtheConnection (AzHeC), in collaboration with Mercy Care Plan and Mercy Maricopa Integrated Care, will assist 2500 local Arizona providers in transforming their practices and move into a value based purchasing payment model. This combined team, named the Practice Innovation Institute (Pii), will work with these practices and support them during the transformation process by providing technology tools, onsite support and training/education that is specific to their patient base and will help them achieve the TCPI goals of effectiveness and efficiency of care.

We are looking for someone with experience in a Pediatric practice setting.

Fundamental Components:

The Practice Transformation Consultant will be part of a high-performing team and will be responsible for management of relationships with key providers who are engaged in the Practice Innovation Institute. The PTC will be responsible for carrying out our value based strategies through the following activities: Monitoring analytics and utilization/quality/cost trends including high-risk member identification and early identification of care intervention for our Pii network. Work across the provider organization and local care community to drive relationships and care coordination to ensure the full continuum of care is available to our members including building relationships with LTSS, behavioral health, pharmacy, community- based providers, patient-centered medical homes, health homes, community mental health centers. Will be the interface between Pi Institute leadership and the transformative clinics. Will work with our provider partners to establish, enhance, or refine programs and create protocols for training and support of practices enabling them to focus on readmission programs, transitions of care and integrated care management. Lead regular meetings with the provider clinical care teams to ensure program implementation with a focus on optimal care coordination, program innovation, clinical decision making, contract execution and evaluation. Will provide education and support on population health management tools and integrated care management programs and processes reinforcing a member-centered approach to care coordination for providers. Continually seeking out new opportunities to enhance, improve and optimize local care delivery and member engagement through clinical/social programming, data sharing or technology.


2-3 years of experience with driving integrated care management preferably within an accountable care organization or value based provider organization or health plan. Excellent written, verbal and presentation skills to professional or member audiences. Expert analytical and critical thinking skills to drive care management, risk stratification and predictive modeling using novel approaches.


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


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Job Function: Management