Aetna Senior Clinical Strategist in Tampa, Florida
Req ID: 52800BR
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).
10+ years strong background in health care analysis methods and tools, Population health, care management including disease management, complex care and end of life.
Ability to collaborate with and understand the needs of C-level executives and help translate those needs to an actionable plan.
Outstanding verbal and written communication skills, including formal presentations for all levels of management combined with strong collaboration/influencing abilities. 5-10 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
Project Management experience required
The highest level of education required for candidates in this position is a Bachelor's degree or equivalent experience.
LICENSES AND CERTIFICATIONS
Nursing/Registered Nurse (RN) or 10 years of experience in Administrative Director level position
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: Management
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.