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Exec. Director, JV Clinical Transformation

Primary Location: Hartford, CT
Additional Locations: AZ-Phoenix, CA-Sacramento, DC-Washington, IL-Chicago, MN-Minneapolis, OH-New Albany, PA-Philadelphia, PA-Pittsburgh, TX-Dallas, TX-Houston, TX-San Antonio, VA-Falls Church
The position reports directly to the Head of Commercial Care Management. The Head of JV Clinical Transformation provides strategic leadership for the development of provider centric assessments and performance improvement strategies, road map, tools, and methodologies. S/he leads the East and West teams of clinicians and business leaders and is responsible for maintaining a highly productive and motivating work environment to achieve business goals and deliver superior solutions for transforming Joint Venture partners across MA and Commercial Lines of Business.

S/he develops population health strategy and implements performance improvement capabilities designed to enable Strategic, Business and Clinical Transformation within provider organizations to help achieve the triple aim. Leads the implementation of solutions with provider organizations and provides work stream oversight across multiple teams. The Exec Director also provides leadership in the development and implementation of transformation plans to achieve targeted improvement goals. S/he collaborates with other leaders within Aetna, the transformation team and across CVS Health to identify enabling technology and service products, clinical programs, and approaches that integrate informatics and performance improvement for population health strategies.

Fundamental Components:
Assesses providers’ capability infrastructure for population health management (Pre deal/concurrent with reviews)
  • Develop/prepare for Sr leadership presentations for JV clinical performance
  • Accountable for managing the providers' financial risk of ~ $250M for each region
  • Interacts, presents, & engages w/ C-suite level JV & provider partners throughout the transformation journey
  • Design/develop/oversee implementation of a comprehensive customized strategy & roadmap to drive a successful population health management capabilities/operational approaches for each of the JV provider partners
  • Capture/elevate to Sr Leadership the feedback from the marketplace & provider community that will shape the clinical strategies going forward (CPI)
  • Support the JV teams/provider partners through the implementation of the recommendations
  • Provides consultation/advisory support to the JV & Health System CMO’s internal staff/provider to close the gaps in capabilities
  • Monitoring/tracking clinical performance against the defined targets; engage with providers in deep dive projects for process improvement and review of technology enablement
  • Partner w/Enterprise clinical team in implementing & deploying various skills and transformation projects applicable to the JVs
  • Manages projects, people, customer expectations & business priorities to achieve constituent satisfaction
  • Oversees day-to-day activities of the team; manages/builds a strong team through formal training, diverse assignments, coaching, mentoring & development techniques.
  • Challenges the status quo - drives transformation activity that will realign current health care processes
  • Motivates and is willing to understand/probe into technical details; mentors others to do the same.
  • Drives the overall design or methodology of tactical/strategic advisory solutions that satisfy needs across products, segments & clients to increase engagement.
  • Communicates/consults with Sr Leadership to ensure that informatics & performance improvement strategies focus on long term results and represent all constituencies effectively
  • Manages budgets, plans and expenses for large scale strategic projects; participates in cost center mgmt
  • Collaborates w/external provider partner and internal leaders/stakeholders to design, implement & improve outcomes tracking & measurement models related to Provider Transformation
  • Collaborates w/business partners to provide advice on clinical strategy that drive metrics, tools & outcomes models for development & evaluation of projects and programs
  • Proactively builds/maintains internal/external key relationships
  • Oversee identification & tracking of proof points for the JVs to be used in the sales process
  • Develop/implement data sharing strategies that enable appropriate & timely interventions
  • Working with JV CMOs, establish annual savings targets that are forward priced into the product
  • Evolve JV clinical models to meet the needs of a dynamic market
  • Develop, test and scale new use cases for integrated clinical & claims data

Background Experience:
  • 10-15 years strong background in population health programs & analysis methods, tools, health economics, VBC finance and clinical program development
  • Levels of management - strong collaboration/influencing abilities
  • Minimum 12 years managerial and project management experience required
  • 5-10 years in both payer and provider settings highly preferred
  • Ability to collaborate with & understand the needs of C-level executives; help translate those needs to an actionable plan. Demonstrated ability to communicate technical concepts & implications to business and policy decision-makers and clients
  • Outstanding verbal/written communication skills, including formal presentations
  • Deep knowledge of health care industry, policy, research design, predictive modeling, ACO finance methods and tools
  • Strategic business acumen and proven organizational, management, and leadership skills
  • Demonstrated: 1) collaborative style, with ability to influence leadership and diverse teams and build strong relationships. 2) Strategic thinking, problem solving and critical thinking abilities. 3) Success leading direct, indirect, and virtual teams in a matrixed environment successful direct report leadership and coaching experience. 4) Ability to negotiate complex and opposing points of view; reach consensus and work through people to achieve key goals
  • Financial acumen and experience with VBC financial models. Experienced working with clinical and claims data
  • Successful experience working with clinicians, finance & operational leaders to drive performance improvement experience
  • 40-50% travel required

Additional Job Information:
Clinical Degree (RN, SW, MD preferred) MPH MBA or MS in management, finance or a related healthcare discipline required.
Working on the Joint Ventures at Aetna 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, working in partnership with leading providers. We are inspired to make a difference, and to empower people to live healthier lives.

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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