What does it mean to work at Aetna? A lot. From programs and benefits that support your financial, physical and emotional health to opportunities to build your knowledge and expand your career, the company makes working here a valuable experience in many ways.

POSITION SUMMARY

The Manager is responsible for oversight/management of medical services staff including the organization and development of high performing teams.

Responsibilities also include the following:

- Responsible for the implementation of Aetna's medical management services policies and procedures.

- Communicates strategic plan and specific tactics to meet plan. Ensures implementation of tactics to meet strategic direction for case management/patient management cost and quality outcomes.

- Creates direction and communicates a business case for change by focusing on and addressing key priorities to achieve business results.

- Ensures regional consistency with national program strategic direction and design.

- Identifies opportunities to implement best practice approaches and introduce innovations to better address the member's needs across the continuum of care.

- Accountable for meeting the financial, operational and quality objectives of the unit.

* Must be an active RN or LCW/LSW in PA or be able to get license soon. * Position in Philadelphia - City Center * Managing a team of clinical professionals. * Managed care, payer, insurance experience. * Medicaid and or Medicare experience preferred. * CCM preferred.

The highest 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

FUNCTIONAL EXPERIENCES

Administration

- Operations/Management: < 25 employees/1-3 Years

Medical Management

- Medical Management - Case Management/1-3 Years

- Management - Administration/1-3 Years

Nursing

- Case Management/4-6 Years

Project Management

- Cross-functional project management/1-3 Years

TECHNOLOGY EXPERIENCES

Aetna Applications/CaseTrakker/1-3 Years/Power User

Desktop Tools (1-3 Years/Power User)

- Microsoft Excel

- Microsoft Word

- Microsoft Visio

REQUIRED SKILLS

Benefits Management

- A mastery in Maximizing Healthcare Quality

Leadership

- Advanced skills in Collaborating for Results

- A mastery in Engaging and Developing People

DESIRED SKILLS

Benefits Management

- Advanced skills in Promoting Health Information Technology

Technology

- Advanced skills in Leveraging Technology

General Business

- A mastery in Demonstrating Business and Industry Acumen

ADDITIONAL JOB INFORMATION

Position will oversee 13-15 direct reports in a Medicaid MCO, including nursing, social work and care coordination (non clinical) staff.

Should have experience serving pediatric and adult members with special health care needs. Knowledge of Pennsylvania Medicaid a plus. W

ill work in fast paced environment to meet turnaround times and compliance for contract with Pennsylvania Department of Public Welfare.

Knowledge of NCQA accreditation standards for case management and ability to promote quality standards for an integrated care management program essential.

HOW TO APPLY

To learn more about this opportunity, visit us at www.aetna.com/working . Under requisition # select 6161BR and submit your resume.

We value leadership, creativity and initiative. If you share those values and a commitment to excellence and innovation, consider a career with Aetna.

We conduct pre-employment drug and background testing.

Aetna does not permit the use of tobacco related products or drugs in the workplace.

Aetna is an Equal Opportunity/Affirmative Action Employer. M/F/D/V

Aetna is committed to maintaining an environment in which all employees are treated equitably and given the opportunity within the context of the business to achieve their potential. Aetna's Affirmative Action responsibilities extend to women, minorities, persons with disabilities and veterans. Company policy also provides for equal opportunity for qualified individuals regardless of race, color, sex, national origin, religion, age, disability, veteran status, sexual orientation, gender identity or marital status.

No search firms please.

You will not be asked for personal information until you have been fully evaluated through Aetna's screening processes. Aetna will never ask applicants for money. If you want to verify the identity of someone who contacts you from Aetna, call 1-800-AETNAHR (1-800-238-6247).