Aetna Registered Nurse (RN) - Program Manager (Medicare Provider Collaboration) in Blue Bell, Pennsylvania

Req ID: 44839BR

POSITION SUMMARY

As a Registered Nurse (RN) - Program Manager, you will work with assigned Medicare provider collaboration groups to drive improved performance by leading performance improvement projects and managing multiple complex deliverables through to implementation. Projects will support population health and will impact Stars, quality, utilization and costs. Orchestrates clinical team by bringing together key internal and external partners to achieve goals. This position will support the development and implementation of new care models supporting value based arrangements.

Fundamental Components of the Registered Nurse (RN) Program Manager include, but are not limited to:

The RN Program Manager works to drive 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 desired:

3 plus years of clinical experience working in a physical health environment 1 plus years of supervisory experience Active and good standing Registered Nurse (RN) license required. Strong communication and interpersonal skills. Proven track record in meeting project milestones and negotiating for resources. Proven negotiation skills. Proven project management skills. Proven success while working in a matrixed environment Supervisory or leadership experience.

EDUCATION

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

LICENSES AND CERTIFICATIONS

Nursing/Registered Nurse (RN) is required.

Managed Care/Managed Healthcare Professional is a plus.

Telework Specifications:

Candidates within the state of Pennsylvania are preferred but New Jersey is also a potential. Position would be assigned to nearest office. There is flexibility for qualified current Aetna WAH associates.

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/4-6 Years

Functional - General Management/Project management (non-IT)/1-3 Years

TECHNOLOGY EXPERIENCES

Technical - Desktop Tools/Microsoft PowerPoint/4-6 Years/End User

Technical - Desktop Tools/Microsoft SharePoint/1-3 Years/End User

Technical - Desktop Tools/TE Microsoft Excel/4-6 Years/End User

Technical - Desktop Tools/Microsoft Outlook/4-6 Years/End User

REQUIRED SKILLS

General Business/Applying Reasoned Judgment/MASTERY

General Business/Demonstrating Business and Industry Acumen/ADVANCED

Leadership/Anticipating and Innovating/ADVANCED

DESIRED SKILLS

Leadership/Creating Accountability/ADVANCED

Leadership/Developing and Executing Strategy/ADVANCED

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 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 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: Management