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
Clinical Health Service Supervisor (RN)Primary Location: High Point, North Carolina
Additional Locations: NC-High Point Apply
Standard business hours with occasional weekend and evening shift 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 15-20 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.
62169Fundamental 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: -5+ years in clinical area of expertise required
-1+ year of experience in managed care setting required
-1+ year of case management, concurrent review, or utilization management experience is required
-RN with current, unrestricted licensure in state in which work is being done required
-Willingness to obtain RN licensure in other states as needed
-BSN is preferred 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.Functional Skills: Clinical / Medical - Concurrent review / discharge planning, Nursing - Case Management Technology Experience: Aetna Application - Aetna Total clinical View, Aetna Application - TE Aetna Strategic Desktop, Desktop Tool - Microsoft PowerPoint, Desktop Tool - Microsoft Word Education: Nursing - Certified Case Manager (CCM), Nursing - Registered Nurse 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.
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