Manager, OhioRISE Clinical Health Services
Core
Develop and implement clinical health services strategies, policies, and programs to drive quality healthcare delivery and competitive business advantage for Aetna OhioRISE.
Role type
Manager, Clinical Health Services
Builds
Quality management and clinical coverage programs
Domain
Health insurance / Managed care
Deliverable
production ML models | product features | dashboards & analysis | research | client delivery | infrastructure | physical/clinical work
Required skills
Clinical licensure (RN/LPCC/LISW), team leadership, strategic planning, financial and operational management, data analysis, regulatory compliance, change management
Preferred skills
Managed care experience, Medicaid experience, QuickBase familiarity, remote work experience, pediatric/adolescent care experience
Technologies
MS Office Suite, QuickBase, EHR portals, Teams, Outlook, Excel, SharePoint
Responsibilities
Reinforce clinical philosophy and procedures; communicate strategic plans and tactics; ensure implementation of tactics for cost and quality outcomes; create business cases for change; identify opportunities for best practices and innovation; manage financial, operational, and quality objectives; oversee team performance and development; act as a single point of contact for customers; participate in recruitment; evaluate data to improve outcomes; address performance management needs; meet KPIs; collaborate with regulatory personnel.
Seniority
Manager, hands-on leadership
