Aetna Licensed Transfer of Care Coordinator - KS MCD - 51961BR in Overland Park, Kansas
Req ID: 51961BR
The Transfer of Care Coordinator is dedicated to the KanCare contract with demonstrated expertise in facilitating and coordinating care transitions across the continuum of care settings and throughout the Members lifespan. This position is responsible for working across internal business units and directly coordinating with care coordination staff, external community entities and participating providers to provide advice and support for complex transition of care cases. This position is also 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.
Oversees the implementation of healthcare management services for assigned functional area.
Implements clinical policies & procedures in accordance with applicable regulatory and accreditation standards (e.g. NCQA, URAC, state and federal standards and mandates as applicable).
Serves as a content model expert and mentor to the team regarding practice standards, quality of interventions, problem resolution and critical thinking.
Ensures implementation and monitoring of best practice approaches and innovations to better address the member's needs across the continuum of care.
Protects the confidentiality of member information and adheres to company policies regarding confidentiality.
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.
Develops, initiates, monitors and communicates performance expectations.
Ensures the team's understanding and use of information system capability and functionality.
Participates 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.
Establishes an environment and work style that promotes the concept of teamwork, cross product integration, and continuum of care thinking that results in strong performance.
Consistently demonstrates the ability to serve as an model change agent and lead change efforts.
Creates a positive work environment by acknowledging team contributions, soliciting input, and offering personal assistance, when needed.
Accountable for maintaining compliance with policies and procedures and implements them at the employee level.
May have responsibility for their own case load work.
May act as a liaison with other key business areas.
May develop/assist in development and/review new training content.
May collaborate/deliver inter- and intra-departmental training sessions.
- May act as a single point of contact for the customer and the Account Team including: participation in customer meetings, implementation and oversight of customer cultural requirements, and support implementation of new customers.
May provide support to the sales staff & network staff via onsite customer visits and/or presentations)
Minimum of 3 - 5 years in clinical area of expertise required.
Minimum of 1-3 years of CM experience required.
Minimum of 1-3 years supervisory experience including previous staffing and hiring experience, new employee onboarding, mentoring and coaching staff required.
Demonstrated expertise in facilitating and coordinating care transitions across the continuum of care settings and throughout the Members lifespan required.
Knowledge of community resources and provider networks required.
MCO experience is required.
Computer literacy and advanced proficiency with Microsoft Excel, Word, and web-based applications is required
Ability to communicate effectively with Providers, Members, staff and other leaders both in verbal, written and presentation formats required.
Ability to evaluate and interpret data, identify areas of improvement, and focus on interventions to improve outcomes required.
- Ability to interview, select teams and work with people in such a manner as to build high morale and group commitment to goals and objectives required.
Ability to multitask, prioritize and effectively adapt to a fast paced changing environment required.
Travel with personal vehicle may be required; must have dependable transportation, valid and active KS driver's license and proof of vehicle insurance.
Reporting: ability to understand and create reports with productivity and service metrics; identify gaps strongly preferred.
Experience working with diverse teams and populations strongly preferred.
IDD (Intellectual or Developmental Disability) experience strongly preferred.
ICM, LTSS and BH experience strongly preferred.
The minimum level of education required for candidates in this position is a Bachelor's degree (BSN preferred) with active, unrestricted KS State RN License OR a Master's degree in the Behavioral Health field with active, unrestricted KS State licensure in applicable functional area (LPC, LCSW).
Bachelor's degree (BSN preferred) with active, unrestricted KS State RN (Registered Nurse) License
Master's degree in the Behavioral Health field with active, unrestricted KS State licensure in applicable functional area (LPC, LCSW).
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 candidate'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