Aetna Workers' Comp MCO Product Director in Plano, Texas

Req ID: 41827BR

POSITION SUMMARY

The Coventry Workers' Comp Managed Care Organization (MCO) Product Director will be primarily responsible for our Texas Health Care Networks (HCNs), to include filings, audits, new implementations and program enhancements.

Fundamental Components:

We are looking for a dynamic Managed Care Organization Product Director to guide our Texas Health Care Networks (HCNs) to the next level. The successful candidate will oversee existing our HCNs and be responsible for the development of new opportunities. The MCO Product Director must be familiar with all Chapters of the Texas Admin Code (TAC) Title 28, Part 2 and all Sections of the Texas Insurance Code Title 8, Chapter 1305, governing certified HCNs in Texas. The successful candidate will have demonstrated experience in implementing and maintaining certified Workers' Comp networks, preferably within Texas. The MCO Product Director will be responsible for keeping up to date with regulatory changes that affect our networks and our customers, interfacing directly with the Texas Department of Insurance and keeping our clients up to date on changes that affect them.

BACKGROUND/EXPERIENCE desired:· 5+ years experience in developing and maintaining certified workers' comp MCOs, preferably HCNs in Texas· 7+ years related cross-functional, project management experience· Exhibits strong ability to handle multiple priorities and drive results to meet deadlines.· Strong attention to details and communication skills (verbal and oral).EDUCATION

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

FUNCTIONAL EXPERIENCES

Functional - Network Management/Network market leadership/4-6 Years

Functional - Products-Other/Workers Compensation/7-10 Years

Functional - Communications/Provider communications/4-6 Years

Functional - Medical Management/Medical Management - Workers compensation/4-6 Years

Functional - Sales & Service/Strategy development/4-6 Years

Telework Specifications:

Flexible telework / office-based schedule.

ADDITIONAL JOB INFORMATION

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.

Job Function: Marketing