Aetna Clinical Performance Lead in New York, New York

Req ID: 54268BR

POSITION SUMMARY

The Clinical Performance Lead provides strategic leadership for the development of clinical performance and operational dashboards, validation of trends for JVs and ACOs, and delivery of future clinical engagement analytics strategies and reporting tools.

Acts as the analytic team lead for Clinical Transformation for highly complex projects involving multiple resources and tasks, providing individual mentoring in support of company objectives.

Develops, tracks and manages clinical performance for JVs and ACO book of business, SAI target setting and manages book of business remediation planning.

Fundamental Components:

Leads development and execution of new and/or highly complex models and leads the strategy with business partners in MEU and Data Sciences

Determines auditing and automation approaches with clinical performance management

Establishes analytical rigor and statistical methods to analyze large amounts of data, using advanced statistical techniques and analyses.

Manages highly complex analytical projects from data exploration, model building, performance evaluation and testing.

Applies in-depth knowledge of systems and products to consult and advise on additional efforts across organization/enterprise.

Motivates team members and probes into technical details, and mentors others to do the same.

Provides thought leadership and direction for clinical Performance and Management process utilizing analytic solutions, tools and studies.

Anticipates and solves strategic and high risk business problems with broad impact on the business area by applying leading-edge theories and techniques to investigate problems, detect patterns and recommend solutions.

Provides guidance to develop enterprise-wide provider clinical analytics strategy and roadmap.

Interacts with internal and external peers and leadership to share highly complex information/solutions related to areas of expertise and/or to gain acceptance of new or enhanced technology/ business solutions.

BACKGROUND/EXPERIENCE:

5-10 or more years of progressively complex related experience in Provider and Clinical performance.

Demonstrates advanced in-depth specialization analysis methods, statistical

analyses, and predictive modeling.

Experience with SAS, R and Tableau.

Comprehensive knowledge on health care industry, products, systems, business strategies and products.

Expertise in advanced analytics tools and languages to analyze large data set from multiple data sources.

Superior skills to effectively communicate and negotiate across the business and in the external health care environment.

Superior ability to communicate technical ideas and results to non-technical clients in written and verbal form.

Strong organizational, management and leadership skills.

Excellent analytical and problem solving skills.

EDUCATION

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

ADDITIONAL JOB INFORMATION

  • Travel requirement is up to 25%.

    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 candidates'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:

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.