At Aetna, a CVS Health Company, 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
Director, Clinical Health Services - MLTSS (RN)Primary Location: Princeton, New Jersey
Additional Locations: NJ-Princeton Apply
Oversees the implementation and on-going execution of the strategic and operational business plan for the business segment's clinical operations, inbound/outbound call queue, implementation, and/or plan sponsor operations. Coordinates business segment policies and procedures in support of financial, operational and service requirements.
68835Fundamental Components: Develop and manage clinical operations focused on improving clinical and financial outcomes, member engagement, and satisfaction Serve as liaison with regulatory and accrediting agencies and other health business units Formulate and implement strategy for achieving applicable department/unit metrics and provide operational direction Serve as technical, professional and business resource (may cross multiple business functions) Develop and participate in presentations and consultations to existing and prospective customers Direct/provide enhancements to business processes, policies and infrastructure to improve operational efficiency (may cross multiple business functions) Participates in internal and external health industry development efforts Develop, implement, and evaluate policies and procedures, which meet business needs (may cross multiple business functions) Implements and monitors business plan and oversees any implementations or business transitions impacting service operations. Collaborates and partners with other business areas across/within regions or segments and within other centralized corporate areas to ensure all workflow processes and interdependencies are identified and addressed on an on-going basis. Promote a clear vision aligned with company values and direction; sets specific challenging and achievable objectives and action plans; motivates others to balance customer needs and business success; challenges self and others to look to the future to create quality products, services, and solutions. Background Experience: 3+ years of clinical leadership experience is required
RN with current unrestricted NJ state licensure is required
Managed care experience is required
Ability to synthesize program performance and clinical outcomes is required
Must be comfortable using Microsoft Office Suite (Word, Excel, Outlook)
MLTSS experience is strongly preferred
New Jersey Choice certification is preferred Education: Nursing - Registered Nurse 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. 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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