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Medical Director, Medicare VBC

Primary Location: Chicago, IL
Additional Locations: AL-Birmingham, CO-Denver, CT-Hartford, FL-Ft Lauderdale, FL-Miami, GA-Atlanta, IL-Chicago, MA-Boston, MD-Baltimore, ME-Portland, MI-Detroit, MI-Lansing, MN-Minneapolis, MO-Springfield, NC-Raleigh, NE-Omaha, NH-Stratham, NJ-Hudson County, NM-Albuquerque, NY-New York, OH-Cincinnati, OK-Tulsa, PA-Philadelphia County, RI-Providence, SC-Greenville, SD-Aberdeen, TN-Nashville, TX-Austin, TX-Dallas, TX-San Antonio, VA-Fairfax, VT- Burlington, WI-Waukesha, WV-Berkeley
The Medical Director is both an internally and externally facing Medicare position that will develop, implement, support, and promote Health Services strategies, tactics, policies, and programs that drive the delivery of quality healthcare to establish a competitive business advantage for Aetna. The Medical Director will interface with external Medicare provider partners to drive enhanced population health and optimize overall provider performance on quality, utilization and cost metrics. The Medical Director will also participate in the development, implementation, and evaluation of clinical/medical programs.

Fundamental Components:
The VBC Medical Director will drive optimized performance and enhanced value by: • Forging strong relationships with external providers; • Establishing partnerships across the internal matrix with Network, internal clinicians and other subject matter experts; • Providing clinical expertise, leadership and guidance to the Medicare Provider Collaboration team; • Analyzing utilization and outcome data to identify gaps and actionable opportunities and communicating those opportunities with internal and external teams; • Participating in the development of action plans that promote population health, enhanced quality for members and overall performance improvement; and • Collaborating with local provider systems to influence care management programs.

Background Experience:
2-3 years of experience in Health Care Delivery System e.g., Clinical Practice and Health Care Industry. Active and current state medical license without encumbrances M.D. or D.O., Board Certification in a recognized specialty including post-graduate direct patient care experience required, Family Medicine, Internal Medicine or Geriatrics preferred.. Managed Care experience preferred.

Additional Job Information:
This position will support the development and implementation of new care models supporting value based arrangements. Aetna is about more than just doing a job. This is our opportunity to re-shape healthcare for America. We are developing solutions to improve the quality and affordability of healthcare. What we do may benefit future generations. 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.

Required Skills:
Benefits Management - Interacting with Medical Professionals, General Business - Communicating for Impact, Leadership - Collaborating for Results

Desired Skills:
General Business - Demonstrating Business and Industry Acumen, Leadership - Anticipating and Innovating, Leadership - Developing and Executing Strategy

Functional Skills:
Clinical / Medical - Concurrent review / discharge planning, Clinical / Medical - Direct patient care (hospital, private practice), Clinical / Medical - General Management, Leadership - Act as company spokesperson to external constituents, Medical Management - Medical Management - Managed Care/Insurance Clinical Staff

Technology Experience:
Desktop Tool - Microsoft Outlook, Desktop Tool - Microsoft PowerPoint, Desktop Tool - Microsoft SharePoint, Desktop Tool - TE Microsoft Excel

Medical - Board Certified, American Board Of Family Practice, Medical - Board Certified, American Board Of Internal Medicine, Medical - Medical License (for all states)

Potential Telework Position:

Percent of Travel Required:
10 - 25%

EEO Statement:
Aetna is an Equal Opportunity, Affirmative Action Employer

Benefit Eligibility:
Benefit eligibility may vary by position.

Candidate Privacy Information:
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.

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