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A new day in healthcare. Together, CVS Health and Aetna help people on their path to better health.

Business Project Manager - RN

Primary Location: Pittsburgh, Pennsylvania
Additional Locations: PA-Pittsburgh
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POSITION SUMMARY
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.

Fundamental Components:
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

BACKGROUND/EXPERIENCE:
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


EDUCATION
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 EXPERIENCES
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


TECHNOLOGY EXPERIENCES
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


DESIRED SKILLS
Leadership/Creating Accountability/ADVANCED
Leadership/Developing and Executing Strategy/ADVANCED
Leadership/Driving Change/ADVANCED


Telework Specifications:
WAH from Western PA

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.

Click To Review Our Benefits (PDF)

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