Job Description

Job Description
This position is temporarily working from home due to Covid 19. Once Covid restrictions are lifted, this role will be office based in New Albany, OH.

Standard business hours are required Monday-Friday with flexibility to work later when needed to support business needs.

What is A1A?

Aetna One Advocate is Aetnas premier service and clinical offering for Aetna nation-wide and creates industry-leading solutions for our customers and members. The model is a fully integrated population health and customer service solution for large plan sponsors high-touch, high-tech member advocacy service which combines data-driven processes with the expertise of highly trained clinical and concierge member services. The mission of this model is designed to meet each member at every aspect of their health care journey. Our embedded customer-dedicated service and clinical pods allow maximization of inbound and outbound touchpoints to solve members needs and create behavior change. Our data analytics, white-glove service and end-to-end ownership of member support creates a trusted partner in health. This is an exciting time to join Aetna a CVS Health company in our journey to change the way healthcare is delivered today. We are health care innovators.

Leads a team of Case Manager Registered Nurses.

Oversees the implementation of clinical management services for A1A customers in assigned pods.
Reinforces clinical philosophy, implements clinical policies & procedures in accordance with applicable regulatory and accreditation standards (e.g. NCQA, URAC, state and federal standards and mandates as applicable).
Serve as a content model expert and mentor to the team regarding practice standards, quality of interventions, problem resolution and critical thinking.
Participate in the recruitment and hiring process for staff using clearly defined requirements in terms of education, experience, technical and performance skills.
Assess developmental needs and collaborate with others to identify and implement action plans that support the development of high performing teams.
Evaluate and interpret data, identify areas of improvement, and focus on interventions to improve outcomes.
Ensures implementation of tactics to meet strategic direction for cost and quality outcomes. Accountable for meeting the financial, operational and quality objectives of the unit.
Works closely with functional area managers to ensure consistency in clinical interventions supporting our plan sponsors.
Establish an environment and work style that promotes the concept of teamwork, cross product integration, and continuum of care thinking that results in strong performance.
Consistently demonstrates the ability to serve as a model change agent and lead change efforts.

The A1A Supervisor of Clinical Services is responsible for oversight of the clinical team supporting the AetnaOne Advocate Program.
The Supervisor is responsible for leading teams of 15-20 clinical resources and non-clinical resources and development of a best in class, high performing teams.
The Supervisor works closely with other functional area Managers to
ensure consistency in clinical interventions, implementation of clinical policy and processes to ensure the delivery of high quality clinical programs and services.

Required Qualifications
-Active and good standing RN license required
-3+ years in clinical area of expertise required
-1.5+ years of managed care setting required
-1+ years of leadership experience required

Preferred Qualifications
See above

Education
Bachelors Degree or the equivalent experience

Business Overview
At Aetna, a CVS Health company, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.

We are committed to maintaining a diverse and inclusive workplace. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, gender, gender identity, age, disability or protected veteran status. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.