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Medicare VBC Engagement Manager

Primary Location: Downers Grove, IL
Additional Locations: IL-Chicago, IL-Downers Grove, IN-Ft Wayne, MI-Detroit, WI-Waukesha
The Engagement Manager will report to the Sr. Dir. Network Management. He/she is responsible for coordinating all types of provider interactions in order to implement and maintain a robust and successful Performance Network /value-based-contract (VBC) with targeted providers in the service area. This includes assisting with setup and on-going maintenance of technology / care management engagement and guidance from subject matter experts as needed. He/she will interact with providers on a regular basis to handle provider requests and concerns while managing and engaging the providers in advanced reimbursement and value based solutions necessary to realize the terms of the VBC arrangement. He/she will coordinate cross-functional groups across the Aetna organization to carry out these servicing activities, many of which are not lead by groups within the Aetna organization (e.g., Clinical Transformation, IT, Informatics, etc). He/she works to ensure that the Performance Network providers / VBC arrangements are functioning successfully and the VBC arrangement is working to improve quality of care while reducing costs.

Fundamental Components:
Manages a cross-functional team of various Aetna, client and external resources to implement and maintain ongoing account services in VBC 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 Establishes and maintains relationships across the Aetna organizations to use as support for these provider servicing activities Manages servicing operations on a routine basis, including setting cadence for regular task activities, as well as responding to live direction requests from Engagement Managers Regularly interfaces with provider to facilitate implementation / maintenance of provider servicing activities and to respond to provider requests / concerns Ensures adherence to compliance policies and procedures throughout provider account operations, proactively identifying risks and escalating to leadership as appropriate Responsible for ensuring that provider account services contribute to the objective of improving quality of care while reducing costs

Background Experience:
Proven ability to interact with, influence and collaborate with clients at all levels 5+ years of project management experience in a health plan, health system or provider organization. 8+ years of client management. 8+ years of hospital system and/or health insurance industry experience, ACO / managed-care experience preferred. Experience managing matrixed staff with ability to leverage non-directs to complete tasks. Proven track record managing complex projects and or programs that resulted in cost savings. Good interpersonal and communication skills and ability to form strong client relationships. Knowledge of healthcare and insurance industry. Bachelor's Degree Required

Additional Job Information:
Team leadership and team building skills.Analytical and planning skills.Negotiation/influencing skills.Relationship and change management skills.Organizational skills.Time management skills.Critical thinking skills.Oral and written communication skills.

Potential Telework Position:

Percent of Travel Required:
25 - 50%

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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