Associate Manager, Clinical Health Services OhioRISE (Multi-region)
Core
Develop, implement, and oversee 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
Required skills
Team leadership, strategic planning, policy implementation, financial management, performance management, regulatory compliance, data analysis, change management, stakeholder communication
Preferred skills
Managed care experience, Medicaid experience, QuickBase familiarity, remote work experience, pediatric/adolescent clinical expertise
Technologies
MS Office Suite (Outlook, Word, Excel, Sharepoint, Teams), QuickBase, EHR portals, VPN
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; manage team performance and development; recruit and hire staff; maintain compliance with policies; evaluate data to identify improvement areas; address performance management needs; meet KPIs and business metrics; collaborate with functional area managers; act as single point of contact for customers; participate in customer meetings; work with internal, external, and state regulatory personnel.
Seniority
Manager, hands-on leadership
