Aetna Veterans Jobs

Job Information

Aetna Clinical Team Lead - Commercial Precert in Dallas, Texas

Req ID: 66213BR

Job Description

The Team Lead is accountable to leadership to support the day to day operations of the team. This position has no supervisory oversight of staff, but requires a solid understanding of the workflows, policies and procedures to ensure the team is producing at a successful level. The Team Lead supports the onboarding of new staff as well as quality monitoring and assignment triage. The Team Lead is a single point and first line of contact for staff for clinical issues. They may lead projects as assigned. The Team Lead provides ongoing communication and updates to leadership and contributes and participates in team meetings. The role requires promoting cooperation and team-building between all department members.

Fundamental Components included but are not limited to:

Serve as a resource to team members() Serve as a content model expert and mentor to the team regarding practice standard, quality of interventions, problem resolution and critical thinking Ensure adherence to plan sponsor performance targets() Develop, implement and support program policies and procedures() Utilize critical thinking skills to raise the level of team�s performance Mentor the team; monitoring and providing feedback regarding performance relative to best practices Act as a role model for the Aetna values, particularly regarding company policies on confidentiality() Communicate effectively with a variety of audiences Well organized and able to prioritize tasks Support a positive work environment that promotes the concept of teamwork Support to Supervisors as directed May have responsibility for their own case load work Respond to issues and inquiries as needed Sedentary work involving periods of sitting, talking, hearing, work requires visual acuity to perform close inspection of hand written and computer generated documents as well as a PC monitor.

Qualifications Requirements and Preferences:

3+ years of clinical experience required

Registered Nurse

Managed Care experience preferred

2+ years of Utilization Management experience required

2+ years of Precert experience preferred

Excellent critical thinking skills

Computer literacy (Microsoft Outlook, Excel and Word)

Strong customer service skills

Licenses/Certifications:

Nursing - Registered Nurse

Functional Skills:

Clinical / Medical - Precertification, Nursing - Clinical coverage and policies, Nursing - Legal and benefit interpretation, Nursing - Medical-Surgical Care

Technology Experience:

Aetna Application - Aetna Total clinical View

Required Skills:

Benefits Management - Interacting with Medical Professionals, Benefits Management - Maximizing Healthcare Quality, Benefits Management - Understanding Clinical Impacts

Desired Skills:

Leadership - Collaborating for Results, Service - Working Across Boundaries

Additional Job Information:

The Team Lead will be responsible for being the first line for operational questions from staff, organize and conduct audits and training as needed, assist in trouble shooting issues, and will work closely with Supervisors.

Benefit Eligibility

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

Job Function: Healthcare

Aetna is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected Veterans status.

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