Aetna (Registered Nurse) RN Senior Clinical Strategist - 51892BR in Phoenix, Arizona
Req ID: 51892BR
Facilitates improvement across multiple ACOs relative to improved management of medical spend, quality measures and
member satisfaction. Develops and manages agenda of prioritized savings plan and initiatives to improve care delivery for
each assigned ACO network.
Analyzes medical spend data and identifies key improvement opportunities for ACO to address. Communicates
compelling and concise results to empower client groups in decision making regarding initiative opportunities.
Provides recommendations around the identification and implementation of care transformation programs within the
client organization that will improve quality, increase efficiency and drive cost savings. Opportunities may include
reduction of admissions, better member alignment and engagement with primary care physicians, enhanced post
discharge follow-up and improvement in closing quality care gaps.
Facilitates ACO leadership team to develop improvement initiatives to address prioritized savings opportunities. May
include development of collaborative workflows, enhanced communication tools and processes and creation of
reporting indicators (leading and lagging measures) to track success.
Promotes effective change leadership and facilitates issue resolution and speed to solution for each ACO in
addressing their transformation roadmap. Responsible for achieving at least 2% annually in medical spend savings for
each ACO and demonstrating improvement in quality measure completion. Strives to help each assigned ACO attain
their contractual savings and quality targets so that ACS relationship remains strong and successful.
Collaborates with Market Operations, ACS marketing and sales and National Accounts team to create messaging on
the value-add of our ACOs. Supports Plan Sponsor interactions to demonstrate the value of ACO relationship to Plan
sponsor and their employees.
Participates in the assessment of providers capability infrastructure for population health management and identifies
any capability gaps that need to be addressed for success with ACS product offering or risk based arrangement. (pre
and post deal with ACS).
BACKGROUND/EXPERIENCE: 8-10+ years strong background in health care analysis methods and tools, Population health, care management including disease management, complex care or end of life; RequiredAbility to collaborate with and understand the needs of C-level executives and help translate those needs to an actionable plan; RequiredOutstanding verbal and written communication skills, including formal presentations for all levels of management combined with strong collaboration/influencing abilities; Required5-10 years in either payer or provider settings; Highly Preferred.Deep knowledge of health care industry, policy, research design, predictive modeling, ACO finance methods and tools.Strategic business acumen and proven organizational, management, and leadership skills.
The minimum level of education desired for candidates in this position is a Bachelor's degree or equivalent experience.
LICENSES AND CERTIFICATIONS
Nursing/Registered Nurse (RN) is Required
Candidate will work from home and may need to travel for meetings
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: Management