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Aetna RN Program Manager in Seattle, Washington

Req ID: 65749BR

Job Description

Works with assigned Aetna Medicare Provider Collaboration groups to drive improved performance by leading clinical performance improvement projects and managing multiple complex deliverables through to implementation. this position will focus on Provider Collaboration Lite arrangements. Projects will support population health and will primarily impact Stars and quality but may also focus on improvements in utilization and costs.

Travel to WA, OR and CA.

Fundamental Components included but are not limited to:

The RN Program Manager works to drive clinical 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 SME s 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.

Qualifications Requirements and Preferences:

Strong communication and interpersonal skills

Proven track record in meeting project milestones and negotiating for resources.

Proven negotiation skills.

1 year+ experience proven project management skills.

1 year+ proven success while working in a matrixed environment Supervisory or leadership experience

Experience Creating Accountability, Developing and Executing Strategy and Driving Change preferred

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/1-3 Years

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

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

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

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






Nursing - Registered Nurse

Functional Skills:

Medical Management - Medical Management - Managed Care/Insurance Clinical Staff, Nursing - Case Management, Nursing - Medical-Surgical Care

Technology Experience:

Desktop Tool - Microsoft Outlook, Desktop Tool - Microsoft PowerPoint, Desktop Tool - Microsoft SharePoint, Desktop Tool - TE Microsoft Excel

Desired Skills:

Leadership - Creating Accountability, Leadership - Developing and Executing Strategy, Leadership - Driving Change

Additional Job Information:

This position will support the development and implementation of new care models supporting value based arrangements. 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. 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

Benefit eligibility may vary by position. Click here to review the benefits associated with this position.

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.