Aetna Director Clinical Health Services (RN, LPC, or LCSW) in New Albany, Ohio

Req ID: 52219BR


Oversees the implementation and on-going execution of the strategic and operational business plan for the business segment's clinical operations, productivity, staffing, inbound/outbound call queue, implementation, and/or plan sponsor operations. Coordinates business segment policies and procedures in support of financial, operational and service requirements.

Fundamental Components but not limited to the following:

Develop and manage clinical operations focused on improving clinical and financial outcomes, member engagement, and satisfaction

Serve as liaison with regulatory and accrediting agencies and other health business units

Formulate and implement strategy for achieving applicable department/unit metrics and provide operational direction

Serve as technical, professional and business resource (may cross multiple business functions)

Develop and participate in presentations and consultations to existing and prospective customers

Direct/provide enhancements to business processes, policies and infrastructure to improve operational efficiency (may cross multiple business functions)

Participates in internal and external health industry development efforts

Develop, implement, and evaluate policies and procedures, which meet business needs (may cross multiple business functions)

Implements and monitors business plan and oversees any implementations or business transitions impacting service operations.

Collaborates and partners with other business areas across/within regions or segments and within other centralized corporate areas to ensure all workflow processes and interdependencies are identified and addressed on an on-going basis.

Promote a clear vision aligned with company values and direction; sets specific challenging and achievable objectives and action plans; motivates others to balance customer needs and business success; challenges self and others to look to the future to create quality products, services, and solutions.

Exhibits the following Employee Behaviors

We listen to and respect our customers and each other so we can act with insight, understanding and compassion.

Trust and respect each other

Be open to all voices and ideas

Be supportive, caring and optimistic

We strive to deliver the highest quality and value possible through simple, easy and relevant solutions.

Be passionate about the people we serve

Set high expectations; be accountable

Partner with others to improve our healthcare marketplace

We inspire each other to explore ideas that can make the world a better place.

Anticipate the future and innovate

Coach, mentor and continuously learn

Be courageous and try new things

We do the right thing for the right reason.

Honor commitments; keep our promises

Behave ethically and act with integrity

Communicate with candor


8-10 years clinical leadership required of remote and onsite employees

(Prefers to have managed staff of up to 100)

Ability to synthesize program performance and clinical outcomes required

Lean Six Sigma belt preferred


The highest level of education desired for candidates in this position is a Master's degree or equivalent experience.

Master's degree in behavioral health field; or Registered Nurse (Masters preferred)

LICENSES AND CERTIFICATIONS one of the following is required:

Nursing/Registered Nurse (RN)

Mental Health/Licensed Clinical Social Worker

Mental Health/Licensed Professional Counselor

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


Functional - Nursing/Case Management/7-10 Years

Functional - Nursing/Mental Health/7-10 Years

Functional - Management/Management - Multifunctional management :> 25 employees/7-10 Years


Technical - Operating Systems/Windows/7-10 Years/End User


Schedule for this role is as necessary.

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 hereto review the benefits associated with this position.

Aetna takes our candidates's data privacy seriously. At no time will any Aetna recruiter or employee request any financial or personal information (Social Security Number, Credit card information for direct deposit, etc.) from you via e-mail. Any requests for information will be discussed prior and will be conducted through a secure website provided by the recruiter. Should you be asked for such information, please notify us immediately.

Job Function: Health Care