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Medicare Advantage D-SNP Business Manager

Primary Location: Detroit, MI
Additional Locations: IL-Hinsdale, IN-Evansville, IN-Ft Wayne, IN-Indianapolis, MI-Detroit, MI-Grand Rapids, MI-Kalamazoo, MI-Lansing, MI-Marquette, MI-Midland, MI-Okemos, MI-Southfield
**Qualified candidates will be located in the Detroit, MI metro area, southern Michigan or Northern Indiana**

The DSNP Program Manager is responsible on a dotted line basis for all aspects of Medicare Advantage Duals Special Needs Plans in assigned markets. This includes oversight, management, coordination of membership, sales, community relationships/activation, provider network, clinical outcomes, financial performance, quality and member experience. Works collaboratively with market based functions, enterprise functions, Medicare and Medicaid corporate functions and the National DSNP Program Office.

Fundamental Components:
Manages and coordinates all aspects of Medicare Advantage Duals Special Needs Plans. This key role will be the business owner for this growing program – working with and through the National DSNP Program Office, connecting and aligning functional areas, with Medicaid as appropriate and enhancing collaboration to assure success. Responsible for sales and membership growth, marketing and sales team guidance and support including the development of training, community relationships/activation, provider network structure, quality, clinical outcomes and care management delivery, Star ratings, member experience, product design, and financial performance.


Background Experience:
10+ years managed care / health insurance industry experience. 3-5 years’ experience with Dual Special Needs Plan and/or a Medicaid managed care program that includes duals and DSNPs. Multiple years proven leadership experience setting strategic direction and influencing change that resulted in quantifiable positive outcomes. Proven record of accomplishment managing complex projects and or programs that resulted in cost savings and working in a complex matrixed organization. Experience working with external healthcare providers or health systems Experience managing large budgets. Project management experience. Supervisory experience. Demonstrated negotiation skills.

Additional Job Information:
Highly visible role in Aetna's priority growth area. Exposure to internal and external leaders with strong growth potential as the business expands.

Required Skills:
General Business - Applying Reasoned Judgment, General Business - Communicating for Impact, General Business - Demonstrating Business and Industry Acumen

Functional Skills:
General Management - Project management (non-IT), Lega - Compliance - state/federal legislation implementation, Project Management - Cross-functional project management

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

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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