Aetna Supvr, Clinical Hlth Svc in Chicago, Illinois

Req ID: 37054BR

POSITION SUMMARY

The Supervisor is responsible for oversight of healthcare management staff including the organization and development of high performing teams. Works closely with functional area managers to ensure consistency in clinical interventions supporting our members. Accountable for meeting the financial, operational and quality objectives of the unit.

Fundamental Components:

Medical Management - monitors daily performance to ensure business goals are met and compliance with policies and procedures is maintained

  • Implements clinical policies & procedures in accordance with NCQA, URAC, state and federal standards and mandate

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

  • Ensure implementation and monitoring of best practice approaches and innovations to better address the member's needs across the continuum of care

  • Manages resources responsible for identification of members, development and implementation of care plans, enhancement of medical appropriateness and quality of care and monitoring, evaluating and documenting of care

  • Communicates productivity expectations, balance workload

  • Ensures the team's understanding and use of information system capability and functionality

  • Assesses developmental needs and collaborates with others to identify and implement action plans that support the development of high performing teams

  • Establish an environment and work style that promotes the concept of teamwork, cross product integration, and continuum of care thinking that results in strong performance

  • Articulate performance expectations and team objectives while collecting and interpreting balanced measure to evaluate individual staff and team performance

  • Lead change efforts while managing transitions within a team

  • Create a positive work environment by acknowledging team contributions, soliciting input, and offering personal assistance, when needed

  • Ability to communicate effectively with providers, members, staff & upper Management

    BACKGROUND/EXPERIENCE desired:

    Requires a current unrestrictive state licensure RN , BSN desirable.

    3-5 years clinical experience

    At least 3 years previous management experience, preferably in a managed care setting.

    High degree of UM/CM expertise in a health plan setting.

    EDUCATION

    The highest 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

    Nursing/Certified Case Manager (CCM) is desired

    FUNCTIONAL EXPERIENCES

    Functional - Nursing/Concurrent Review/discharge planning/4-6 Years

    Functional - Nursing/Discharge Planning/4-6 Years

    TECHNOLOGY EXPERIENCES

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

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

    Telework Specifications:

    Telework considered for current internal teleworkers.

    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.

    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.

Job Function: Health Care