Aetna Manager, Clinical Health Services (RN) in Blue Bell, Pennsylvania
Req ID: 50863BR
Applicants need to live in PA.
Develop, implement, support, and promote Health Services strategies, tactics, policies, and programs that drive the delivery of quality healthcare to establish competitive business advantage for Aetna. Health Services strategies, policies, and programs are comprised of utilization management, quality management, network management, and clinical coverage and polices.
Fundamental Components include, but are not limited to:
Reinforces clinical programs. Ensures implementation of tactics.
Communicates a business case for change and key priorities to achieve business results.
Identifies opportunities to implement. Accountable for meeting the financial, operational and quality objectives.
Accountable for oversight of the day to day management of clinical teams. Works closely with other managers.
Monitor and communicate performance expectations.
Participate in recruitment.
Assess and develop action plans.
Serves as a model change agent and lead change efforts. Accountable for maintaining compliance.
Ability to evaluate and interpret data. Remains calm and constructive during tense or stressful situations.
Performs tasks outside area of responsibility when needed. Revises priorities to respond to change.
5-7 years in clinical area of expertise; required
5 years management experience; required
Managed Care experience; required
Utilization Management experience; preferred
The minimum level of education desired for candidates in this position is a Associate's degree or equivalent experience.
LICENSES AND CERTIFICATIONS
Nursing/Registered Nurse is required
Functional - Nursing/Concurrent Review/discharge planning/4-6 Years
Functional - Nursing/Clinical coverage and policies/4-6 Years
Functional - Clinical / Medical/General Management/4-6 Years
Functional - Nursing/Quality Management/4-6 Years
Technical - Desktop Tools/Microsoft Explorer/4-6 Years/End User
Technical - Desktop Tools/Microsoft Word/4-6 Years/End User
Technical - Desktop Tools/TE Microsoft Excel/4-6 Years/End User
Candidate need to reside in PA
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.
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