Aetna Medicare / Medicaid Special Needs Plan Senior Business Manager - PA/ WV / DE (52461BR) in Pittsburgh, Pennsylvania

Req ID: 52461BR

Dual Eligible - Special Needs Plan Senior Business Manager - PA/ WV / DE

Telework Specifications:

Considered only for locations in a specific region, state, or city; Training period in the office may be required. Must live full time in Pennsylvania in the Philadelphia, Harrisburg or Pittsburgh areas

Manager of the Dual Eligible- Special Needs Plan (SNP) business in PA/WV/DE. Responsible for all aspects of program on a dotted line basis - membership, sales, community relationships/activation, provider network, clinical outcomes, financial performance, quality and member experience. Great, highly visible role in the largest growing segment in Aetna's flagship market. Exposure to internal and external leaders with strong growth potential as the business expands.

Fundamental Components:

(*) Manager of all aspects of the PA/WV/DE Special Needs Plans.

(*) This key role will be the business owner for this growing program - connecting the functional areas and enhancing collaboration to assure success.

Responsible for:

(*) Sales and membership

(*) Marketing and sales team guidance and support including the development of training

(*) Community relationships/activation

(*) Provider network structure and quality

(*) Clinical outcomes and care management delivery

(*) Financial performance

(*) STARS ratings and Quality

(*) Member experience

(*) Product Design


(*) 10+ years managed care / health insurance industry experience.

(*) 3-5 years experience with dual eligible Special Needs Plan or a Medicaid managed care program

(*) Multiple years proven leadership experience setting strategic direction and influencing change that resulted in quantifiable positive outcomes.

(*) Proven track record managing complex projects and or programs that resulted in cost savings.

(*) Experience working with external healthcare providers or health systems

(*) Experience managing large budgets.

(*) Project management experience.

(*) Supervisory experience.

(*) Demonstrated negotiation skills.


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


General Business/Demonstrating Business and Industry Acumen/MASTERY


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: Management