Description: Considering candidates in the Western region of the US as well as the Northeastern region of the US.
The Provider Collaboration Clinician is responsible for a defined population in the assigned provider group(s). The clinician will use practice-wide data to identify clinical trends and opportunities for improvement and will partner with practice leadership to generate improvements for the practice as a whole. In addition, the clinician will assess, plan, implement, and coordinate case management activities with specific assigned members through telephonic and/or face to face interaction.
Fundamental Components: Reviews and analyzes data analytics reports for a population of people to identify and assess clinical trends, root causes, and opportunities for improvement in assigned provider groups. Trends may be based on cost data, diagnoses, utilization, etc. of the population.Presents findings and recommended clinical actions to practice leadership and works collaboratively to resolve issues and improve performance and clinical outcomes for the group. Tracks progress of initiatives through continued data analysis, making additional recommendations as needed. Anticipates the needs of assigned provider patient population, assisting the practice to identify members in need of proactive clinical care such as but not limited to well visits. Assesses and evaluates holistic needs of assigned members utilizing the case management process to identify gaps in care and/or barriers to care and implement solutions. Background Experience: RN licensure required 5+ years clinical experience required
Case management experience preferred CCM preferred Managed care experience preferred Proficiency with computer skills which includes navigating multiple systems and keyboarding Proficient in Word, especially Excel with knowledge on how to sort and filter data Additional Job Information: Typical office working environment with productivity and quality expectations Work requires the ability to perform close inspection of hand written and computer generated documents as well as a PC monitor. Sedentary work involving periods of sitting, talking, listening. Work requires sitting for extended periods, talking on the telephone and typing on the computer. Ability to effectively prioritize and execute tasks in a high-pressure environment based on changing priorities. Ability to work collaboratively and consultatively with executive level customers. Excellent writing skills, including the ability to prepare high quality written reports from diverse materials and inputs. Excellent oral communication skills, both in small group meetings and in large meetings of 50 or more persons, including the ability to prepare and present effective and compelling power point slides. Strong data analysis and clinical skills with the ability to utilize data to as a tool to assist in tracking and trending clinical outcomes and clinical information.
WORK LOCATION - CO, WA, AZ, UT, CA, OR Education: Nursing - Registered Nurse Potential Telework Position: Yes Percent of Travel Required: 0 - 10% EEO Statement: Aetna is an Equal Opportunity, Affirmative Action Employer Benefit Eligibility: 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.