Lead DSNP Operations Consultant (Telework) (70008BR)Primary Location: Albany, NY
Additional Locations: CT-Hartford, FL-Tampa, IL-Chicago, NY-Albany, PA-Blue Bell, TX-Houston Apply
(*) Ensures that systems (administrative and clinical) are aligned with Medicare DSNP requirements (administrative and model of care), product and benefit designs, and state Medicaid agency contract requirements.
(*) Works with functional areas to ensure that systems and processes are appropriately configured to drive enrollment, claims, care management, customer and provider services, and member facing portals or tools.
(*) Lead must understand related operations and process that support these functions. Will support planning and implementation of DSNP integration and data sharing requirements.
(*) Collaborates and partners with other business areas across/within segments or other business areas to ensure all workflow processes and interdependencies are identified and addressed.
(*) Accountable to ensure all member internal/external portals are appropriately configured and displayed for all DSNP requirements. This includes, but is not limited to, accumulators, cost share displays, alignment with DSNP member materials, etc.
(*) Focus on operational processes, operational reporting, and improvements targeted to support our DSNP members' experience.
- Previous experience (7+ years) in Medicare and leading strategic initiatives
- Strong written and communication skills
- Strong presentation and facilitation skills
- Strong DSNP knowledge including: operations, enrollment, clinical and claims
- Strong understanding of DSNP plans, regulations and SMACs
- Ability to quickly identify gaps and recommend enhancements related to assigned areas.
- Medicaid knowledge desired
- Ability to lead and drive integration requirements across Medicaid and Medicare DSNP
- Other work as assigned by the DSNP Program Office
Jobs for you
Recently Viewed Jobs
You do not have any recently viewed jobs
Your Saved Jobs
You do not have any saved jobs
Sign up for Job Alerts
Join our Talent Community
At Aetna, a CVS Health Company, we are pioneering a total approach to health and wellness and we need talented candidates like you to join our team. Become a member of our talent community to be the first to know about career initiatives that match your skills and interests as they become available, in addition to details on upcoming events, networking opportunities, and news about Aetna, a CVS Health Company.Sign Up
Join Our Talent Community
Sign up to receive information about job openings that are tailored to your skills and interests. Plus, get the latest career news from Aetna, a CVS Health Company.