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Aetna STAR Kids Service Coordination Manager in Dallas, Texas

Req ID: 68426BR

Job Description

Leadership of STAR Kids Service Coordination team, providing direction and oversight of related processes through the development and management of high performing teams. Has accountability for all aspects of service coordination for members, including highly complex and broad reaching programs or initiatives that include medical, behavioral, and social determinates of health services. Responsible for comprehensive care coordination ensuring that members holistic health needs are met in a caring and culturally sensitive manner. This position is office based with minimal travel of 10% anticipated. Must have valid and active TX drivers license, reliable transportation, and vehicle insurance.

Fundamental Components included but are not limited to:

  • Reinforces clinical philosophy, programs, policies and procedures.

  • Communicates strategic plan and specific tactics to meet plan. Ensures implementation of tactics to meet strategic direction for cost and quality outcomes.

  • Creates direction and communicates a business case for change by focusing on and addressing key priorities to achieve business results.

  • Identifies opportunities to implement best practice approaches and introduce innovations to better improve outcomes.

  • Accountable for meeting the financial, operational and quality objectives of the unit.

  • Oversight of day-to-day management of teams for appropriate implementation and adherence with established practices, policies and procedures

  • Works closely with functional area supervisors to ensure consistency in clinical interventions supporting our plan sponsors.

  • Develop, initiate, monitor and communicate performance expectations.

  • Participate in the recruitment and hiring process for staff using clearly defined requirements in terms of education, experience, technical and performance skills.

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

  • Consistently demonstrates the ability to serve as a model change agent and lead change efforts.

  • Accountable for maintaining compliance with policies and procedures and implements them at the employee level.

  • Ability to evaluate and interpret data, identify areas of improvement, and focuses on interventions to improve outcomes.

Qualifications Requirements and Preferences:

5+ years in clinical area of expertise.

Active unrestricted State Licensure in applicable functional area. (eg RN, LMSW, LPC, LCSW)

Registered Nurse (BSN preferred) OR A Master's degree in behavioral health field

Managed care and health plan experience is preferred

Licenses/Certifications:

Mental Health - Licensed Clinical Social Worker, Mental Health - Licensed Master Social Worker (LMSW), Mental Health - Licensed Professional Counselor, Nursing - Registered Nurse (RN)

Functional Skills:

Clinical / Medical - Direct patient care (hospital, private practice), Clinical / Medical - Management: < 25 employees, Medical Management - Medical Management - Case Management

Technology Experience:

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

Required Skills:

Benefits Management - Interacting with Medical Professionals, Benefits Management - Maximizing Healthcare Quality, Benefits Management - Understanding Clinical Impacts

Desired Skills:

General Business - Demonstrating Business and Industry Acumen, Leadership - Creating Accountability, Leadership - Engaging and Developing People

Additional Job Information:

At Aetna Better Health of Texas, we are committed to helping people on their path to better health. By taking a total and connected approach to health, we guide and support our members so they can get more out of life, every day. We are looking for people like you who value excellence, integrity, caring and innovation. As an employee, you ll join a team dedicated to improving the lives of Texas STAR Kids members. We value diversity and are dedicated to helping you achieve your career goals.

Benefit Eligibility

Benefit eligibility may vary by position.

Job Function: Healthcare

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.

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