Aetna Medical Director (Active Health Management) in Philadelphia, Pennsylvania
Req ID: 50946BR
ActiveHealth Management (AHM) has an opening for a Medical Director. This is a full-time salaried position opportunity supporting traditional AHM customers. Work At Home position with occasional travel as needed to meet with client.
AHM is a national leader in population health management, passionate about helping every person achieve his or her best health. We provide personalized insights and resources through our clinical and consumer analytics, care management, health, lifestyle and wellness programs to help our customers improve quality of care, lower healthcare costs, and drive sustained consumer engagement and behavior change. ActiveHealth® collaborates with employers, health plans, governments and providers currently helping more than 20 million people live their healthiest lives. ActiveHealth Management is an independent subsidiary of Aetna (NYSE: AET) ActiveHealth Management is an independent subsidiary of Aetna (NYSE: AET)
The Medical Director (MD) is responsible for providing clinical expertise and business direction in support of the medical programs provided by AHM, including UM, CM, CareEngine/Care Considerations, Condition Management, and other AHM population health programs and solutions. The MD will promote the delivery of high quality, constituent responsive medical care. Signficant time will be dedicated to UM review. The MD is a critical medical and business leader who will act as a contact for external providers as well as participate in strategic medical management. The MD will join an innovative team at AHM and, as such, will also be a contributor to ongoing clinical product content development across AH's suite of population health solutions.
In this role you will:
-Work collaboratively within the assigned regional care team with medical director staff and other clinicians
-Work cross functionally within ActiveHealth
-Communicate for impact internal and external to Activehealth Management
-Use your sound clinical knowledge and general knowledge of the health benefits business, clinical issues, trends, and medical management principles
-Use your excellent interpersonal skills that bring out the best in medical management staff
-Effective presentation skills are important
-Work in a matrixed and rapidly changing environment
2-3 years of experience in Health Care Delivery System e.g., Clinical Practice and Health Care Industry
Prior UM experience/1-3 Years
Prior Managed care experience /1-3 Years
Active unrestricted Medical Board Certified in Internal Medicine, Family Practice, Pediatrics, Emergency Medicine, or Occupational Medicine preferred; will consider other specialties
The highest level of education desired for candidates in this position is a MD or DO.
LICENSES AND CERTIFICATIONS
Active unrestricted state medical license without restrictions is required.
Current Board Certification in recognized specialty is required.
Board Eligible may be considered if candidate is preparing to sit for required examinations to become Board Certified.
Medical/National Board Of Medical Examiners is desired
Functional - Medical Management/Medical Management - Precertification/1-3 Years
Functional - Medical Management/Medical Management - Concurrent Review/1-3 Years
Functional - Medical Management/Medical Management - Case Management/1-3 Years
Functional - Medical Management/Medical Management - Disease management/1-3 Years
Functional - Medical Management/Medical Management - Quality Management/1-3 Years
Technical - Desktop Tools/Microsoft Outlook/1-3 Years/End User
Technical - Desktop Tools/Microsoft Explorer/1-3 Years/End User
Technical - Desktop Tools/Microsoft Word/1-3 Years/End User
General Business/Communicating for Impact/ADVANCED
General Business/Demonstrating Business and Industry Acumen/ADVANCED
General Business/Turning Data into Information/ADVANCED
Leadership/Driving a Culture of Compliance/FOUNDATION
Leadership/Collaborating for Results/FOUNDATION
Telework will be considered on approval by the Medical Director's Manager.
ADDITIONAL JOB INFORMATION
This is a great opportunity for the candidate to gain experience in integrated population health management and utilization management.The medical director serves as the medical leader for clinical operations and account management, helps improve medical cost trends through data analysis and team interventions, supports sales team as needed, and contributes to clinical product development and enhancement.
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