Aetna Clinical Program Consultant RN in St Louis, Missouri
Req ID: 51815BR
Open to anywhere in the USA and closest to an Aetna office!
This unique Clinical Program Consultant (CPC) role focuses on evaluating the results of a consultant-managed care program for our book of business and providing insights and solutions to improve health plan performance.
External facing role working with account teams and customers and the consultants who manage this care management offering.
Collaborative position - partnered with a dedicated analytic resource working with Aetnas clinical operation teams and Aetnas strategic distribution teams.
Excellent opportunity for a registered nurse to have engagement in an external-facing role leveraging analytic, consultative and presentation skills.
Fundamental Components but not limited to the following:
The Plan Sponsor Insights (PSI) business works in partnership with account teams to assist in the development of employer health and wellness strategies, provide subject matter expertise on Aetnas clinical programs, conducts data analysis of clinical program performance and makes recommendations to help mitigate medical cost trend, and optimize return on investment for our plan sponsors.
Key aspects of the position are:
Recommend solutions for clinical programs and services that align with customer needs and help drive short and long term results
Frequent engagement in consultant and customer-facing meetings including development and presentation of clinical content and recommendations
Partner with analytics resource to identify trends in clinical program outcomes, population health, and utilization patterns
Act as a trusted clinical resource to the field for clinical program guidance
Collaborate across the enterprise and with clinical operations to problem-solve as necessary
Provide consultative clinical support to account teams and plan sponsors as needed based on analysis and identification of key drivers of results
Participate in the design of clinical solutions and measurement of success and share knowledge of population health trends
Strong problem solving skills and attention to detail.
Strong clinical analytic skills and demonstrated conceptual thinking.
Clinician (must be an RN for this role).
Strong background in employer health and welfare knowledge.
Strong background and fundamental knowledge of the healthcare industry and market.
Foundational knowledge of medical management products, programs and services.
Excellent communication and presentation skills (ability to take complex content and facilitate understanding for the audience).
Proven ability to establish highly collaborative relationships within and outside the organization
History of applying critical thinking skills to problem solving.
The minimum level of education desired for candidates in this position is a Bachelor's degree or equivalent experience.
LICENSES AND CERTIFICATIONS
Nursing/Registered Nursing License is required
Health and Fitness/Wellness Councils of America is desired
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General Business/Consulting for Solutions/ADVANCED
General Business/Applying Reasoned Judgment/MASTERY
General Business/Demonstrating Business and Industry Acumen/ADVANCED
General Business/Ensuring Project Discipline/ADVANCED
Flexible telework / office-based schedule (must live near an Aetna office)
ADDITIONAL JOB INFORMATION
Aetna is about more than just doing a job. This is our opportunity to re-shape healthcare for America and across the globe. We are developing solutions to improve the quality and affordability of healthcare. What we do will benefit generations to come.
We care about each other, our customers and our communities. We are inspired to make a difference, and we are committed to integrity and excellence.
Together we will empower people to live healthier lives.
Aetna is an equal opportunity & affirmative action employer. All qualified applicants will receive consideration for employment regardless of personal characteristics or status. We take affirmative action to recruit, select and develop women, people of color, veterans and individuals with disabilities.
We are a company built on excellence. We have a culture that values growth, achievement and diversity and a workplace where your voice can be heard.
Benefit eligibility may vary by position. Click hereto review the benefits associated with this position.
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.
Job Function: Management