Aetna Senior Engagement Manager in McLean, Virginia
Req ID: 49859BR
Responsible for coordinating end to end account servicing in order to implement and maintain provider operations according to the Joint Venture contract. This includes setup and on-going maintenance of tech / care management solutions, organizing consultative services and guidance from subject matter experts as needed, as well as back office functions such as billing, claims and appeals processing. He/she will interact with providers on a regular basis to handle provider requests and concerns while managing routine servicing operations to realize the terms of the JV contract and responding to ad-hoc requests /issues raised by providers and the Joint Venture Management Team. He/she will coordinate cross-functional groups across the Joint Venture, the wider Aetna organization to carry out these servicing activities, many of which are not lead by groups within ACS (e.g.,Medicity, Informatics). He/she works to ensure that the providers / JV are functioning successfully and the JV arrangement is working to improve quality of care while reducing costs.
Provides deal support during Business Development negotiations if applicable
Partners with the Implementation project lead for sold Joint Venture transactions
Sets the strategic vision and tone for the relationship and carries out the operational plan to execute that strategy.
Establishes appropriate governance and management processes to drive strategic direction
Manages a cross-functional team of various Aetna, client and external resources to implement and maintain ongoing account services in JV arrangements with combinations of financial, product, technology, clinical, and operational elements, ranging from infrastructure / network installation for provider solutions, ongoing maintenance of provider solutions (e.g., tech / population health services), payments / appeals processes, report generation, and compliance
Ensures adherence to compliance policies and procedures throughout provider account operations, proactively identifying risks and escalating to leadership as appropriate
Collaborates cross-functionally to monitor performance and customer service efficiencies, including performance guarantees, client and company clinical as well as financial goals.
Looks for ways to enhance the solution with the JV to include identifying new functionality, programs, products, services and technology to ensure better outcomes and achievement of program objectives.
Has ultimate accountability for the project/engagement management services being delivered including the organizations budget and/or financial implications.
Actively reports and resolves issues; removes barriers to successful execution
Manages partner expectations, anticipating possible issues and communicating turnaround times with reasonable delivery dates
Works with the technology lead(s) to support technology prioritization and delivery to ensure adequate infrastructure to support Joint Venture requirements
Provides accurate, timely and insightful analysis in response to ad hoc requests
15+ years of hospital system and/or health insurance industry experience.
15+ years of client management, healthcare industry preferred.
8+ years demonstrated knowledge of healthcare industry and particularly ACOs.
Strong strategic consulting experience with either a provider or payer.
Must have provider or payer experience.
Proven ability to interact with, influence and collaborate with clients at all levels.
Proven experience managing matrixed staff with ability to leverage non direct reports to complete tasks.
Proven track record managing complex projects and/or programs that resulted in cost savings and high customer satisfaction.
Strong interpersonal skills.
The highest level of education desired for candidates in this position is a Bachelor's degree or equivalent experience.
Functional - Project Management/Cross-functional project management/4-6 Years
The position should be located near the Joint Venture in Falls Church, VA.
ADDITIONAL JOB INFORMATION
Masters Degree Preferred
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.
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Job Function: Management