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Business Project Program Manager (DSNP)

Primary Location: Santa Ana, CA
Additional Locations: CA-Santa Ana
Manages the work and deliverables of DSNP program, through to implementation that impact multiple processes, systems, functions and products. This includes coordination of communications, materials, sales, community relationships, provider network, clinical outcomes, regulatory, marketing, quality and member experience. Works collaboratively with market based functions, enterprise functions, Medicare and Medicaid functions and the national DSNP Program office.

Fundamental Components:
Manages, coordinates and implements all aspects of Medicare Advantage Duals Special Needs Plans. Proactively drives a program by based on knowledge and experience of the DSNP program in the state of California. This key role will be the business owner for this growing program - working locally and with the national DSNP program office, connecting and aligning functional areas to assure success. Responsible for development of product design, members materials, sales training materials, marketing and sales team guidance, clinical outcomes and care management delivery that impact Star Ratings and member experience. Able to quickly identify gaps and recommends enhancements related to new product, services and workflows.
Collaborates and partners with other functional managers, other business areas across/within segments or other business areas to ensure all workflow processes and interdependencies are identified and addressed. Leads all project and/or program management work including monitoring and tracking of progress and status update communications.

Background Experience:
10+ years manage care / health insurance industry experience. 3-5 years experience with Dual Special Needs Plan. Experience includes development and management of multiple projects and or program. Proven track record in meeting program milestones. Experience working with external healthcare providers or health systems. Demonstrates excellent communication skills and analytic skills to identify trends and challenges in changing market. BS/BA or equivalent experience. Bilingual capabilities a plus.

Additional Job Information:
Ability to communicate effectively with all levels of management. Attention to details in the planning and implementation of DSNP product and new MA products in CA. Ability to perform effectively in a fast pace environment and contribute to department needs. Team player and performs well under pressure. Proficient in microsoft products (power point, excel, ect). Proven ability to meet deadlines and anticipate trends that may impact business and develop alternatives to resolve issues.

Required Skills:
Leadership - Collaborating for Results, Leadership - Driving a Culture of Compliance, Sales - Knowing Customers

Desired Skills:
Benefits Management - Understanding Clinical Impacts, Sales - Creating Innovative Products, Service - Creating a Differentiated Service Experience

Functional Skills:
Communication - Member communications, Leadership - Lead a major product launch, Management - Management - Medicare, Management - Management - Operations, Project Management - Cross-functional project management

Potential Telework Position:

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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