Aetna Joint Venture Lead Clinical Strategist in Dallas, Texas
Req ID: 54429BR
Responsible for clinical strategy for NewCo health plan, including program strategy, medical trend management, network optimization, partner relationships, and community relationships.
Accountable for the clinical transformational change required to drive overall program results and achieve targeted goals for assigned ACOs/JVs, including a minimum of 2% year-over-year medical cost savings on a portfolio of at least 100,000 members. Informs the region lead of the challenges and formulates ideas, tactics, and strategies as appropriate to work towards the medical cost savings targets
Helps to oversee Clinical Strategists, Sr Transformation Consultants, and Clinical Collaboration Specialists in assigned markets through program oversight, coaching, and mentoring to achieve savings, quality, and membership targets.
Works with Aetna and provider team to deliver customized transformational road maps for clients to build necessary population health capabilities and competencies Facilitates and works in collaboration with other team members and departments (i.e., product, member experience, sales, marketing) to identify, prioritize and implement transformation activities that address population health effectiveness including physician alignment, governance, collaboration strategies, innovation programs, community connections and, consumer/patient/family engagement and competitive differentiation
Manages governance model to seek and maintain executive buy-in from both organizations and the NewCo board, interacting with CEOs, COOs, CMOs, and other population health SMEs.
Manages the highest visibility clients, with complex contractual deals or strategies, requiring strong executive presence and thought leadership.
Accountable for proactively managing implementation challenges and defining solutions to overcome change resistance from client thereby mitigating delays or challenges in attaining roadmap implementation objectives
Accountable for managing the delegation process including collaboration with other departments to determine delegated functions, design processes and work flows, plan IT modifications, develop training and communications, etc.
Each ACO/JV will demonstrate quality measures improvement quarter over quarter as compared to the baseline. Improve Quality across ACOs/JVs
i. 90% of ACOs/JVs with Product membership over 2500 members meet or exceed targets
ii. 100% of ACOs/JVs have plans in place to meet quality targets provided the membership supports setting such metrics.
All new ACOs/JVs will complete a discovery discussion and completion of the roadmap in a timeframe approved by the region lead.
10+ years experience with several of the following methodologies: management consulting, project consulting, business process consulting, financial strategic analysis, mergers and acquisitions, strategic business planning, and/or risk management consulting.
Experience with enterprise-wide and/or cross-functional large scale initiatives with high degree of complexity.
Demonstrated experience successfully implementing change in complex organizations.
Demonstrated superior business process, project management and organizational redesign experience.
Demonstrated leadership with relevant initiatives: Business process, enterprise business project management/consulting, financial strategic planning and analysis, mergers and acquisitions, strategic planning, risk management.
Demonstrated relationship management skills at the senior level; capacity to quickly build and maintain credible relationships at varying levels of the organization simultaneously.
The highest level of education desired for candidates in this position is a Master's degree.
ADDITIONAL JOB INFORMATION
Critical thinking skills.
Time management skills.
Relationship and change management skills.
Analytical and planning skills.
Oral and written communication skills.
Team leadership and team building skills.
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.
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Job Function: Management
Aetna is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected Veterans status.