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Manager, Utilization Management Services

at Aetna Inc.

Posted: 8/22/2019
Job Reference #: 67663
Keywords: supervisor

Job Description

Job Description
Oversight and Management of clinical team processes including the organization and development of high performing teams.

Req#
63304BR

Job Group
Healthcare

Full or Part Time
Full Time

Supervisory Responsibilities
Yes

Percent of Travel Required
10 - 25%

Posting Job Title
Manager, Utilization Management Services

Potential Telework Position
No

Additional Locations
WV-Charleston

Primary Location (City, State)
WV-Charleston

EEO Statement
Aetna is an Equal Opportunity, Affirmative Action Employer

Resource Group
6

Fundamental Components
Reinforces clinical philosophy, programs, policies and procedures. Communicates strategic plan and specific tactics to meet plan. Ensures implementation of tactics to meet strategic direction for cost and quality outcomes. Creates direction and communicates a business case for change by focusing on and addressing key priorities to achieve business results. Identifies opportunities to implement best practice approaches and introduce innovations to better improve outcomes. Accountable for meeting the financial, operational and quality objectives of the unit. May be accountable for the day-to-day management of teams for appropriate implementation and adherence with established practices, policies and procedures if there is not supervisor position Works closely with functional area managers to ensure consistency in clinical interventions supporting our plan sponsors. Develop, initiate, monitor and communicate performance expectations. May act as a single point of contact for the customer and the Account Team which includes participation in customer meetings, implementation and oversight of customer cultural requirements, and support implementation of new customers. Participate in the recruitment and hiring process for staff using clearly defined requirements in terms of education, experience, technical and performance skills. Assesses developmental needs and collaborates with others to identify and implement action plans that support the development of high performing teams. Consistently demonstrates the ability to serve as a model change agent and lead change efforts. Accountable for maintaining compliance with policies and procedures and implements them at the employee level. Ability to evaluate and interpret data, identify areas of improvement, and focuses on interventions to improve outcomes.

Background Experience
2+ years of Utilization Management experience; required 
2+ years of managed care experience; required
1+ years Leadership experience; required
5+ years in clinical area of expertise; Required
Active unrestricted State Licensure in applicable functional area. (eg RN, LPC, LCSW) Master's degree in behavioral health field; or Registered Nurse (BSN preferred)
 

Minimum Education Level
Mental Health - Licensed Clinical Social Worker, Mental Health - Licensed Professional Counselor, Mental Health - Licensed Psychologist, Nursing - Registered Nurse

Benefits Program
Benefit eligibility may vary by position. Click here to review the benefits associated with this position.

Candidate Privacy Information
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.