At Aetna, we’re pioneering a total approach to health and wellness, focusing on the whole person - body, mind, and spirit. Our more than 4,000 nurses are central to turning our member’s health ambitions, big and small, into achievements. Your role will include helping members stay well, manage health conditions, and access the right care at the right time. As you do this, we’ll support you in achieving more in your life and your work.
What makes a successful nurse? Here are the traits we are looking for:
- Problem Solver
- Results Driven
- Technology Savvy
- Detail Oriented
- Good Listener
- Open Minded
- Team Player
Paid Time Off & Disability
Business Project Program Manager - Registered NursePrimary Location: Hays, Kansas
Additional Locations: KS-Hays Apply
Works with assigned Aetna Medicare Provider Collaboration groups to drive improved performance by leading clinical performance improvement projects and managing multiple complex deliverables through to implementation. Projects will support population health and will impact Stars, quality, utilization and costs.
The RN Program Manager works to drive clinical performance of assigned Provider Collaboration groups by:
-Establishing trusting relationship with provider partners to promote open communication
-Serving as clinical expert on actionable opportunities related to CM, gap closure, workflow discussions, and partnering with case manager supervisor/manager and CMs -Serving as internal and external liaison and clinical resource, interpreting data and educating regarding how to utilize data for PC performance improvement
-Strategizing with SMEs and clinical teams both internally and externally to drive outcomes and improve efficiencies
-Coordinating and conducting clinically focused meetings to identify opportunities target and prioritize goals and interventions to close gaps in care and achieve optimal stars performance
-Collaboratively working across multiple functions and /or segments to obtain agreement from all impacted parties (e.g., up and downstream effects often impact multiple functions and/or segments.
-Collaborating with Engagement Managers, Local Market Team, Data Team, Medical Operations and others on initiatives for stars/quality improvement, transformative care model SAIs to align with Aetnas strategic goals
Proven success while working in a matrixed environment Supervisory or leadership experience required
Strong communication and interpersonal skills required
4+ years of Case Management experience preferred
1+ years of Medical-Surgical Care experience preferred
Managed Care experience preferred
1+ years of Project Management (non-IT) experience preferred
4+ years of MS Office Tools experience (Excel, PowerPoint, etc.) preferred
1+ years of Medicare experience preferred
Proven track record in meeting project milestones and negotiating for resources
Proven negotiation skills
The minimum level of education for candidates in this position is a Bachelor's degree or equivalent experience.
LICENSES AND CERTIFICATIONS
Nursing/Nursing License is required
Functional - Nursing/Case Management/4-6 Years
Functional - Nursing/Medical-Surgical Care/1-3 Years
Functional - Medical Management/Medical Management - Managed Care/Insurance Clinical Staff/1-3 Years
Technical - Desktop Tools/Microsoft Outlook/4-6 Years/End User
Technical - Desktop Tools/Microsoft PowerPoint/4-6 Years/End User
Technical - Desktop Tools/TE Microsoft Excel/4-6 Years/End User
Technical - Desktop Tools/Microsoft SharePoint/1-3 Years/End User
Leadership/Developing and Executing Strategy/ADVANCED
WAH from near Overland Park, KS
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 and across the globe. 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.
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.
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