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Joint Venture, Care Management Medical Director - 59663BR

Primary Location: Phoenix, Arizona
Additional Locations: AZ-Phoenix
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Description:
Provide leadership of medical management activities. Develop and implement medical management programs/policies.


#LI-TS1

Fundamental Components:



Leads,
develops, directs and implements clinical and non-clinical activities that
impact health care quality, cost and outcomes. Direct the utilization review
process and oversee the quality of utilization determinations. Ensure compliance
with clinical goals through monitoring care management performance.

Leads
clinical staff in the coordination of quality care. Provides
clinical expertise and business direction in support of medical management
programs through participation in clinical team activities

Acts as
lead business and clinical liaison to network providers and facilities to
support the effective execution of medical
services programs by the clinical teams

Expands medical
management programs to address member needs across the continuum of care

Oversees
triage and referral for Care Management Center




Background Experience:
  • Managed care experience, as provider and manager of care.
  • 3+ years experience (preferably 5+ years) involving substantial direct patient care at multiple levels of care.
  • MD from accredited (ACME) American or Canadian medical school or equivalent training in a foreign medical school with successful completion of ECFMG and FLEX exams.
  • Board certification
  • License or licensure eligibility in state of operation (licensure must be complete within 1st year of employment).
  • Full training in a ACGME approved U.S. or Canadian residency program.
  • Current active license without encumbrances to practice medicine in the U.S..


Functional Skills:
Clinical / Medical - Direct patient care (hospital, private practice)

Technology Experience:
Desktop Tool - TE Microsoft Excel

Education:
Medical - Board Of Medical Examiners

Potential Telework Position:
No

Percent of Travel Required:
10 - 25%

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

Click To Review Our Benefits (PDF)

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