A1A Supervisor, Clinical Health ServicePrimary Location: High Point, NC
Additional Locations: NC-High Point Apply
This role is office based in High Point, NC. Standard business hours are required Monday-Friday with occasional weekend coverage required.The A1A Supervisor of Clinical Services, is responsible for oversight of the clinical team supporting the AetnaOne Advocate Program. The Supervisor is responsible for leading a team of clinical resources and non-clinical resources and development of a best in class, high performing team and is accountable for meeting the financial, operational and quality objectives of the unit. The Supervisor works closely with the A1A Manager as well as the other functional area Managers to ensure consistency in clinical interventions, implementation of clinical policy and processes to ensure the delivery of high quality clinical programs and services.
65683Fundamental Components: -Oversees the implementation of clinical management services for A1A customers in assigned pods
-Reinforces clinical philosophy, implements clinical policies & procedures in accordance with applicable regulatory and accreditation standards (e.g. NCQA, URAC, state and federal standards and mandates as applicable).
-Serve as a content model expert and mentor to the team regarding practice standards, quality of interventions, problem resolution and critical thinking.
-Participate in the recruitment and hiring process for staff using clearly defined requirements in terms of education, experience, technical and performance skills.
-Assess developmental needs and collaborate with others to identify and implement action plans that support the development of high performing teams.
-May act as a single point of contact in conjunction with the A1A Manager for the customer and the Account Team which includes participation in customer meetings, implementation and oversight of customer cultural requirements, and support implementation of new customers.
-Evaluate and interpret data, identify areas of improvement, and focus on interventions to improve outcomes. Ensures implementation of tactics to meet strategic direction for cost and quality outcomes.
-Works to ensure consistency in clinical interventions supporting our plan sponsors.
-Establish an environment and work style that promotes the concept of teamwork, cross product integration, and continuum of care thinking that results in strong performance.
-Consistently demonstrates the ability to serve as an model change agent and lead change efforts. Background Experience: -RN with current, unrestricted licensure in state in which work is being done required
-5+ years in clinical area of expertise required
-3+ years of experience in managed care setting preferred
-2+ years of prior leadership experience required
-Willingness to obtain RN licensure in other states as needed
-BSN or relevant experience required Additional Job Information: Demonstrates highly developed communication and people skills. Ability to engage and interact easily with diverse group of individuals. Strong listener, empathetic and supporting. •Ability to prioritize and multitask in fast paced, deadline driven environment. •Ability to adapt to constantly changing demands and environment. •Strong public speaking and presentation skills. •Demonstrates a commitment to service; accountable for actions and issues resolution, responsive to customer needs. •Ability to work with people in such a manner as to build high morale and group commitment. •Demonstrates strong problem solving skills and ability to work independently. •Ability to evaluate and interpret data, identify areas for improvement and focus on interventions to improve outcomes. •Requires proficiency with computer skills including keyboarding, navigating multiple systems. •Proficiency in use of Microsoft Outlook and Office. •Must be able to work in office setting with extended periods of time sitting, talking on telephone and typing on computer. Required Skills: Leadership - Anticipating and Innovating, Leadership - Collaborating for Results, Leadership - Driving a Culture of Compliance Desired Skills: Leadership - Creating Accountability, Leadership - Driving a Culture of Compliance, Leadership - Engaging and Developing People Functional Skills: Nursing - Case Management, Nursing - Concurrent Review/discharge planning Technology Experience: Aetna Application - Aetna Strategic Desktop Reporting, Aetna Application - Aetna Total clinical View, Desktop Tool - Microsoft Outlook, Desktop Tool - Microsoft Word Education: Nursing - Certified Case Manager (CCM), Nursing - Registered Nurse (RN) Potential Telework Position: No Percent of Travel Required: 0 - 10% EEO Statement: Aetna is an Equal Opportunity, Affirmative Action Employer Benefit Eligibility: Benefit eligibility may vary by position. Click here to review the benefits associated with this 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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