Job Responsibilities: Senior Manager Care Management
Hiring Organization: Aetna Remote Jobs. Inc (WFH)
Educational Requirements: Bachelor Degree
Industry: Private
Employment Type: Full Time
Salary: $35-45$/Year
Aetna Data Entry Jobs For College Students (Part/Full Time, Remote)
Carry your heart to AETNA Wellbeing. All of us at AETNA Wellbeing shares a solitary, clear reason: Carrying our heart to each snapshot of your wellbeing. This reason directs our obligation to convey upgraded human-driven medical care for a quickly influencing world. Moored in our image — with heart at its middle — our motivation sends an individual message that how we convey our administrations is similarly essentially as significant as what we convey.
Our Heart At Work Behaviors™ support this reason. We need each and every individual who works at AETNA Wellbeing to feel engaged by the job they play in changing our way of life and speeding up our capacity to advance and convey answers for make medical care more private, helpful and reasonable.
At Aetna Better Strength of Texas, we are focused on aiding individuals on their way to better wellbeing. By adopting an aggregate and associated strategy to wellbeing, we guide and backing our individuals so they can get more out of life, consistently. We are searching for individuals like you who esteem greatness, respectability, mindful and development. As a worker, you’ll join a group committed to working on the existences of Texas individuals. We esteem variety and are committed to assisting you with accomplishing your vocation objectives.
The Ranking director, Care The board creates, carries out, upholds, and advances wellbeing administrations methodologies, strategies, approaches, and projects that drive the conveyance of value medical services to Aetna Better Soundness of Texas individuals. The Sr. Chief is liable for oversight and the board of Aetna Better Wellbeing Texas Manager(s) which incorporates the association and improvement of high performing groups. Likewise answerable for guaranteeing the working of care the board and care coordination exercises across the continuum of care (surveying, arranging, executing, organizing, observing, and assessing).
This position reports to the Chief, Clinical Wellbeing Administrations, Care Coordination.
This is a remote position, competitor should live in TX
Position Liabilities:
Drives the clinical group that upholds convenient wellbeing risk screenings, thorough evaluations, care plan improvement and part mediations as per the Aetna Better Wellbeing Hazard Definition Level System and Texas legally binding prerequisites.
Fills in as contact with administrative and certifying organizations and other wellbeing specialty units.
Fills in as specialized, proficient and business asset (may cross numerous business capabilities).
Upholds quality improvement projects through effective execution.
Creates, executes, and assesses arrangements and strategies, which address business issues (may cross various business capabilities).
Capacity to orchestrate program execution and clinical results.
Information on the guidelines, principles, and arrangements which connect with clinical administration.
Capacity to discuss in a profoundly powerful way with inner and outside constituents in both composed and oral organization.
Capacity to assess and decipher information for the reasons for checking staff execution, administrative consistence, and advancement of new projects and cycles to fulfill business needs.
Surveys formative necessities and works together with others to recognize and execute activity designs that help the advancement of high performing groups.
Directs all regulatory obligations as per laid out principles for supporting and dealing with a group.
Partakes in the enrollment and recruiting process for staff involving plainly characterized necessities with regards to schooling, experience, specialized and execution abilities.
Creates, starts, screens, and imparts execution assumptions.
Evaluates formative requirements and teams up with others to distinguish and execute activity designs that help the advancement of high performing groups.
Upholds the administration of complicated physical and conduct wellbeing cases by being clinically and socially able with suitable preparation and experience.
Directs routinely booked individual and group gatherings with an emphasis on part administration conveyance, fulfillment of managerial obligations, and satisfying laid out efficiency guidelines.
Directs all regulatory obligations as per laid out principles for supporting and dealing with a group.
Fills in as the Consideration The board well-informed authority with the Aetna Better Soundness of Texas Medicaid endlessly contract expectations.
Guarantees Care The board consistence with contract necessities.
Recognizes chances to carry out best practice draws near and acquaint developments with better further develop results.
Capacity to discuss in a profoundly successful way with inward and outside constituents in both composed and oral organization.
Responsible for gathering the clinical functional and quality targets of the agreement.
Reliably shows the capacity to act as a model change specialist and lead change endeavors.
Responsible for keeping up with consistence with strategies and methodology and carries out them at the worker level.
Guarantees care the executives/care coordination and sickness the board are important for populace wellbeing and quality improvement exercises.
Capacity to assess and decipher information, distinguish areas of progress, and spotlights on mediations to further develop results.
Responsible for interior and outer measurements including part commitment objectives and state prerequisites per contract.
Responsible for supporting state reviews, NCQA execution and reviews and Clinical Technique for RFPs.
Drives the clinical group that upholds convenient wellbeing risk screenings, thorough appraisals, care plan advancement and part mediations as per the Aetna Better Wellbeing Hazard Definition Level System and Texas authoritative necessities.
Fills in as contact with administrative and certifying organizations and other wellbeing specialty units.
Fills in as specialized, proficient and business asset (may cross different business capabilities).
Upholds quality improvement projects through effective execution.
Capacity to assess and decipher information for the motivations behind observing staff execution, administrative consistence, and advancement of new projects and cycles to satisfy business needs.
Surveys formative requirements and teams up with others to recognize and carry out activity designs that help the improvement of high performing groups.
Leads generally regulatory obligations as per laid out principles for supporting and dealing with a group.
Partakes in the enlistment and recruiting process for staff involving obviously characterized prerequisites regarding schooling, experience, specialized and execution abilities.
Creates, starts, screens, and imparts execution assumptions.
Surveys formative requirements and works together with others to distinguish and carry out activity designs that help the improvement of high performing groups.
Upholds the administration of mind boggling physical and social wellbeing cases by being clinically and socially able with proper preparation and experience.
Leads consistently planned individual and group gatherings with an emphasis on part administration conveyance, finish of managerial obligations, and fulfilling laid out efficiency guidelines.
Leads generally regulatory obligations as per laid out guidelines for supporting and dealing with a group.
Fills in as the Consideration The board educated authority with the Aetna Better Wellbeing of Texas Medicaid endlessly contract expectations.
Guarantees Care The board consistence with contract prerequisites.
Distinguishes valuable chances to carry out best practice draws near and acquaint developments with better further develop results.
Capacity to discuss in an exceptionally successful way with inward and outer constituents in both composed and oral organization.
Responsible for gathering the clinical functional and quality targets of the agreement.
Reliably exhibits the capacity to act as a model change specialist and lead change endeavors.
Responsible for keeping up with consistence with approaches and techniques and carries out them at the worker level.
Guarantees care the executives/care coordination and sickness the board are important for populace wellbeing and quality improvement exercises.
Capacity to assess and decipher information, recognize areas of progress, and spotlights on mediations to further develop results.
Responsible for inside and outer measurements including part commitment objectives and state prerequisites per contract.
Responsible for supporting state reviews, NCQA execution and reviews and Clinical Methodology for RFPs.
Creates, carries out, and assesses arrangements and strategies, which address business issues (may cross numerous business capabilities).
Capacity to orchestrate program execution and clinical results.
Information on the guidelines, principles, and arrangements which connect with clinical administration.
Capacity to discuss in a profoundly compelling way with inner and outside constituents in both composed and oral configuration.
Aetna Data Entry Jobs For College Students (Part/Full Time, Remote)
Required Capabilities
Dynamic unhindered Texas State Permit in appropriate utilitarian region. (for example RN,LPC, LCSW)
7 years in clinical specialized topic
7 years administrative/administrative experience
Care the board insight
Information on the guidelines, principles, and strategies which connect with clinical administration.
Care the executives experience
3+ long periods of involvement in PC, console route, and MS Office Suite applications
Favored Capabilities:
Overseen care insight
Confirmed Caseworker (CCM)
Texas Medicaid experience – explicitly TX STAR and CHIP
Schooling
Four year college education expected for RN permit or graduate degree in friendly administrations/clinical advising for BH Permit.
Pay Reach
The run of the mill pay range for this job is:
This pay range addresses the base hourly rate or base yearly full-time compensation for all situations in the gig grade inside which this position falls. The genuine base compensation proposition will rely upon different variables including experience, instruction, topography and other significant elements. This position is qualified for a AETNA Wellbeing reward, commission or transient motivation program I
