Senior Strategic Planner
Req ID: 50659BR
We are expanding our Duals Special Needs Plans (DSNP) department at Aetna and building an exciting new clinical and member experience program. The National DSNP Clinical Operations Department will oversee care management and clinical quality for this growing book of business, nation-wide. We are adding to a small but highly experienced DSNP clinical leadership team as we grow and we are looking for talented, dynamic and passionate people to join us. The Senior Strategic Planner will report to theDirector of National DSNP Clinical Operations and will serve as the lead for planning, implementation and performance management of the DSNP care management program. The Senior Planner must be innovative and not afraid to challenge existing ways of working to continuously improve and enhance our care model and care delivery mechanisms.
Understand and articulate the DSNP business and operational requirements to a clinical workflow application (software) development team including: workflow configuration, business rules and operational reporting requirements. Coordinate operational planning efforts with interdependencies between DSNP care management and other clinical program partners both internal and external to Aetna. Lead regular reviews of operational reporting and program performance. Works closely with clinical operational leadership team to identify and evaluate opportunities for process optimization. Lead projects and initiatives to continuously enhance the clinical program and improve performance of associates and outcomes of the program. Proactively identifies opportunities for improvement and influences others to align through complex negotiations and/or expert consultation that promotes issue resolution. Stimulates strategic thinking and provides thought leadership in support of business direction.
Manages special projects that DSNP, driving and guiding engagement from key influences using a disciplined and repeatable methodology.
Works closely with DSNP and clinical leadership teams to effectively implement new products, programs, and expansion opportunities across the enterprise. Builds optimal and influential partner/vendor relationships; developing and managing the relation long term across all states. Designs, develops, and facilitates work sessions to deliver project and program initiatives including required analysis, reporting, and presentation materials. Identified gaps in projects or programs and challenges self and others to develop and implement solutions. Drives or guides development of holistic solutions and/or key strategic plans; proactively identified opportunities for improvement and influences others to align through complex negotiations and/or expert consultation that promotes issue resolution.
Manage the recruitment and on-boarding of new clinical associates in partnership with other clinical operations leaders and with the support of a project planning / implementation specialist Demonstrates proficiency managing email in an Outlook account and using remote communication software such as Skype and WebEx; able to demonstrate proficient with Word, Excel, MS, Visio, PowerPoint and experience documenting within an electronic health record.
5 years of experience in care management operations
Experience with care management program and staff management in a managed care setting required
Experience with Medicare Duals Special Needs Plans policies, regulations and population needs required
Experience with clinical workflow application development strongly desired
Outstanding communicator and self motivated leader with the ability to communicate upwards and with peers effectively
Strong organizational and time management skills. Resolution focused with high attention to detail, accuracy, problem solving and follow up. Ability to flex work hours at times to meet business needs Thrives in a fast paced work environment
Strong technical skills and proficiency in the utilization of standard MS Office products including Word, Excel, MS, Visio, PowerPoint.
The highest level of education desired for candidates in this position is a Bachelor's degree or equivalent experience.
It is desired that this role be based in Sunrise Florida with other senior members of the National DSNP Clinical Operations teams; candidates may be considered in the following other locations: [PA/KS/MO local Medicare market management team locations] as well as DSNP Georgia location.
ADDITIONAL JOB INFORMATION
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 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.
Job Function: Planning
Website : http://www.aetna.com
Aetna Inc. operates as a diversified health care benefits company in the United States. The company operates in three segments: Health Care, Group Insurance, and Large Case Pensions. The Health Care segment provides medical, pharmacy benefit management, dental, behavioral health, and vision plans on an insured basis, and an employer-funded or administrative basis. This segment also provides Medicare and Medicaid products and services, as well as other medical products, such as medical management and data analytics services, medical stop loss insurance, workers' compensation administrative services, and products that provide access to its provider networks in select markets. This segment offers its products and services to multi-site national, mid-sized, and small employers, as well as individual customers. The Group Insurance segment provides life insurance products comprising group term life insurance, voluntary spouse and dependent term life insurance, group universal life, and accidental death and dismemberment insurance; disability insurance products; and long-term care insurance products, which offer benefits to cover the cost of care in private home settings, adult day care, assisted living, or nursing facilities. This segment provides insurance products principally to employers that sponsor its products for the benefit of their employees and their employees dependents. The Large Case Pensions segment manages various retirement products, including pension and annuity products for tax-qualified pension plans. The companys customers include employer groups, individuals, college students, part-time and hourly workers, health plans, health care providers, governmental units, government-sponsored plans, labor groups, and expatriates. Aetna Inc. was founded in 1853 and is headquartered in Hartford, Connecticut.