Aetna Licensed LTSS Clinical Officer (GNP) - KS MCD in Overland Park, Kansas

Req ID: 54490BR

POSITION SUMMARY

Oversees the implementation and on-going execution of the strategic and operational business plan for the business segment's clinical operations. This position is dedicated to the KanCare Contract and shall oversee and be responsible for all primary, physical and behavioral health services provided to individuals receiving LTSS, and to comparable populations enrolled in KanCare and all clinical activities pertaining to the operation of LTSS programs and services including preventative care and the management and coordination of chronic conditions and physical health needs and the integration and coordination of primary and other physical health services for Members receiving LTSS.

The LTSS Clinical Officer shall also be responsible for working with the CMO, Behavioral Health CMO (BH-CMO), Pharmacy Director and the Behavior Supports Director to ensure the integration of physical and Behavioral Health services and supports and LTSS, as applicable, for individuals in each of these populations and to oversee quality improvement initiatives regarding behavior supports and the appropriate use of psychotropic medications in each of these populations.

Fundamental Components:

  • 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

    Qualification Requirements:

  • Minimum of (5) years of experience in directing health care services for FE or individuals of any age with physical, intellectual and/or developmental disabilities required.

  • Minimum of (8) years of clinical leadership and the ability to synthesize program performance and clinical outcomes required.

  • Managed Care, Medicaid and Medicare experience required.

  • Experience in the local KS market and familiarity with the KanCare program required.

  • Proficiency with PC, keyboard, mouse and MS Office Suite applications required.

    Education:

    The minimum level of education required for this position is a Master's degree.

    Licensure:

    Gerontological Nurse Practitioner (GNP) license for the State of KS is required.

    FUNCTIONAL EXPERIENCES

    Functional - Clinical / Medical/Direct patient care (hospital, private practice)/7-10 Years

    Functional - Medical Management/Medical Management - Managed Care/Insurance Administration/4-6 Years

    Functional - Clinical / Medical/General Management/7-10 Years

    Functional - Nursing/Case Management/7-10 Years

    Functional - Management/Management - Multifunctional management :> 25 employees/4-6 Years

    TECHNOLOGY EXPERIENCES

    Technical - Desktop Tools/Microsoft Word/7-10 Years/End User

    Technical - Desktop Tools/TE Microsoft Excel/7-10 Years/End User

    Technical - Desktop Tools/Microsoft Outlook/7-10 Years/End User

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

    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.

    Benefit eligibility may vary by position. Click here to 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

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.