Aetna Sr Dir, Medical Hlth Svc 41513BR in Richfield, Ohio
Req ID: 41513BR
As the Senior Medical Director (SMD) will responsible for leadership of strategic medical management activities which contribute to the performance of the markets and promotes quality of care for our members. These responsibilities include development and implementation of medical programs/policies, enhancing relationships with providers and facilities, plan sponsor and regulatory agencies and acts as a key business partner in network development, product design, strategic planning and sales support. The Senior Medical Director (SMD) position reports to the Executive Medical Director.
Use your experience with Medicare business; BH experience is a plus. Maintain an appropriate and effective organizational structure to support the business strategy & achieve desired outcomes Provide input to network management for regional market network creation, contracting, fees, & all other related activities necessary to drive optimal results Patient Management organization, including the development, implementation & execution of PM strategy Collaborate with National Medical Policy & National Quality Management Organizations as requested to ensure PM execution is aligned with overall health policy, quality standards & strategy Share responsibility for Regional market compliance & public relations Develop & maintain relationships with local & state medical associations as well as hospital & physician organizations Show significant managed care leadership experience with demonstrated results leading broad scope initiatives & change Show substantial & demonstrated track record of management & leadership success over a range of healthcare delivery programs & operations Candidates will have held market accountabilities for impacting & enhancing healthcare delivery, as well as for the associated financial & operating performance metrics on behalf of an organization Demonstrate a comprehensive knowledge of the healthcare market, and be conversant with diverse functional disciplines from both a strategic & tactical perspective Understand key competitive market dynamics and guide and oversee competitive trends analysis, cognizant of the market-specific issues which exist in the delivery of healthcare programs
3-5 years experience in the health care delivery system e.g., clinical practice and health care industry.
The highest level of education desired for candidates in this position is a MD.
LICENSES AND CERTIFICATIONS
Medical Management/ABMS/AOA - Internal Medicine is desired
Medical/American Board of Internal Medicine is desired
Managed Care/Managed Healthcare Professional is desired
Functional - Medical Management/Medical Management - Clinical coverage and policies/4-6 Years
Functional - Medical Management/Medical Management - Case Management/4-6 Years
Functional - Management/Management - Multifunctional management: < 25 employees/4-6 Years
Functional - Leadership/Lead a complex or multifunctional organization/4-6 Years
General Business/Turning Data into Information/MASTERY
Leadership/Developing and Executing Strategy/MASTERY
Leadership/Driving a Culture of Compliance/MASTERY
General Business/Communicating for Impact/MASTERY
Leadership/Engaging and Developing People/MASTERY
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 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: Health Care