Aetna Clinical Team Lead in Blue Bell, Pennsylvania

Req ID: 45201BR

POSITION SUMMARY

The Team Lead is accountable to leadership to support the day to day operations of a small specialized team handling sensitive, complex, and executive level complaints and appeals. This work also includes identification and resolution of root causes. This position has no supervisory oversight of staff, but requires a solid understanding of the workflows, policies and procedures to ensure the team is producing at a successful level. The Team Lead provides ongoing communication and updates to leadership and contributes and participates in team meetings. The role requires promoting cooperation and team-building between all department members and across departments.

Fundamental Components

Fundamental Components & Physical Requirements include but are not limited to:

Serve as a resource to team members

Serve as a content model expert and mentor to the team regarding quality of interventions, problem resolution and critical thinking

Develop, implement and support program policies and procedures

Utilize critical thinking skills to raise the level of team's performance

Act as a role model for the Aetna values, particularly regarding company policies on confidentiality

Communicate effectively with a variety of audiences

Well organized and able to prioritize tasks

Support a positive work environment that promotes the concept of teamwork

May have responsibility for their own case load work

Respond to issues and inquiries as needed

Requires proficiency with computer skills which includes navigating multiple systems and keyboarding

Time efficient and highly organized

Exceptional communication skills

Ability to mentor and support staff to meet business needs

Proven track record of subject matter expertise

BACKGROUND/EXPERIENCE desired

4+ years clinical and managed care experience is required

Requires proficiency with computer skills which includes navigating multiple systems and keyboarding

Must be time efficient and highly organized

Exceptional written communication skills are required

Experience with clinical reviews strongly preferred, but not required

EDUCATION

The minimum level of education desired for candidates in this position is a Bachelor's degree or equivalent experience.

LICENSES AND CERTIFICATIONS

Nursing/Registered Nurse is required

FUNCTIONAL EXPERIENCES

Functional - Nursing/ 4+ Years

TECHNOLOGY EXPERIENCES

Technical - Aetna Applications//1+ Years

Telework Specifications

  • This position can be worked out of any Aetna office location

  • This position will accommodate current, internal telework (WAH) employees

    ADDITIONAL JOB INFORMATION

    This is very satisfying work with an opportunity to ensure our members receive high quality care and a complete and fair review.

    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: Health Care