Aetna CPC-Clinical Program Consultant-VA in McLean, Virginia

Req ID: 37780BR

POSITION SUMMARY

A valuable contributor to National Accounts by providing clinical insight, clinical expertise, strategic analysis and advisorship for assigned account teams in supporting plan sponsor relationships. Clinical and utilization report analysis, health promotion and wellness strategy consultation, and customer, consultant and account team support are the cornerstones of this position.

TRAVEL-25% by Car, Train and Air in Mid Atlantic Markets

FUNDAMENTAL COMPONENTS:

Review clinical program performance and formulate recommendations for improvement

  • Analyze a plan sponsors member engagement and utilization experience and identify areas of opportunity (clinical programs)

  • Be a resource for clinical programs and services and present as needed

  • Be a resource for industry trends in managing member engagement and medical issues

    *Contribute to the value and impact of Aetnas programs through current program enhancement and future program innovations (clinical programs)

  • Participate in clinical assessments, as needed

  • Collaborate with medical directors and other clinical areas as needed

  • Customer facing presentation of content

  • Preparation of meeting materials in collaboration with account team

  • Establish credibility and respect with team members

  • Connect disparate observations to discover integration opportunities; correlations that drive strategy development; cause and effect implications

  • Proactively demonstrate creative and innovative thinking

    BACKGROUND/EXPERIENCE DESIRED:

    3-5 years experience with one or more of the following: Care management, clinical data analytics, understanding of medical trends, formal presentation experience. Knowledge of health promotion and wellness strategy a plus. Knowledge of clinical systems, medical and pharma. treatments required.

    Registered Nurse, OR LSW-Social Work degree.

    Certified Wellness desirable.

    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 (RN) or LSW required

    Health and Fitness/Wellness Councils of America is desired

    Healthcare Management/Case Manager Society of America (CMSA) is desired

    FUNCTIONAL EXPERIENCES

    Clinical / Medical/Consultative informatics/1-3 Years

    Clinical / Medical/Sales/1-3 Years

    Clinical / Medical/Direct patient care (hospital, private practice)

    Clinical / Medical/Concurrent review / discharge planning

    TECHNOLOGY EXPERIENCES:

    Aetna Applications/Aetna Health Information Advantage

    REQUIRED SKILLS:

    General Business/Communicating for Impact

    General Business/Consulting for Solutions

    General Business/Demonstrating Business and Industry Acumen

    DESIRED SKILLS:

    General Business/Ensuring Project Discipline

    General Business/Managing Sales Relationships

    ADDITIONAL JOB INFORMATION:

    This is an exciting, fast-paced and rewarding position that allows for the combination on clinical and business experience to positively affect the health of large populations. Working within National Accounts, on a small, close knit team of caring professionals is a perk of this position. The department in which this position resides has a best in class culture with focus on work/life balance and strong teamwork. This job offers the balance of telework and periodic travel to satisfy the human interaction that is sometimes missed when working from home.

    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: Management