Mar 26, 2020

Director, Provider Performance Technology

  • Professional Diversity Network
  • Fort Lauderdale, FL, USA
Full-Time Other

Job Description

Aetna

Description:

Typically manages work teams and/or most complex projects through to implementation. Follows strategic direction through operationalization. These projects are often national in scope which may impact one or all segments, and typically runs multiple years in duration with high financial implications. Has full accountability for all operational aspects of projects and or programs under the direction of the senior manager.


Manage and be accountable for multiple work teams and/or many complex projects to implementation through a population based platform.

*Will be responsible for providing daily operational oversight with a matrixed team as required in support of technology initiatives. May be responsible for concurrent initiatives (such as Medicaid/Commercial pilots) as team lead and/or team member, based on resource requirements.

*Must have knowledge of Medicare/Commercial/Medicaid concepts (Stars, Risk Adjustment, HEDIS)

*Must have experience in evaluation of Value-based concepts (levels of risk arrangements, levers to pull to negotiate)

*Must understand and will perform dataset reviews with ability to find anomalies using historical trends, this is a requirement with expansion into additional LOB

*Will manage and be accountable for the population health team under the lead of the Senior Director (2-3 direct reports), develop, set priorities and manage enhancements, successfully to implementation.

69936

Fundamental Components: Sets the direction of the business plan and translates into vision for staff/others As a business leader, influences all stake holders to support key projects/programs to ensure positive outcomes that deliver on results. Drives change in order to improve performance results, organization effectiveness and/or systems/quality/services (e.g., policies, processes or systems). Identifies gaps in processes or organization and challenges self and others to develop and implement solutions. Directs accountability for impact to SG&A - Ensures accurate prioritization of key projects/programs within purview. Has ultimate accountability for project management services being delivered including organizationïs budget and/or financial implications. Typically manages staff. Background Experience: Proven track record managing complex projects and or programs that resulted in cost savings. Multiple years proven leadership experience setting direction and influencing change that resulted in quantifiable positive outcomes. 5-10+ years managed care / health insurance industry experience. Project management experience. Supervisory experience. Bachelor's degree or equivalent experience.

*Must have knowledge of Medicare/Commercial/Medicaid concepts (Stars, Risk Adjustment, HEDIS)

*Must have experience in evaluation of Value-based concepts (levels of risk arrangements, levers to pull to negotiate)

*Must understand and will perform dataset reviews with ability to find anomalies using historical trends, this is a requirement with expansion into additional LOB

Additional Job Information: Ability to communicate effectively with management.
Ability to run projects in multiple geographies.
Must have experience with excel.
Required Skills: General Business - Demonstrating Business and Industry Acumen, General Business - Turning Data into Information, Leadership - Creating Accountability Desired Skills: Benefits Management - Promoting Health Information Technology, Benefits Management - Understanding Clinical Impacts, Leadership - Driving Change Functional Skills: Leadership - Lead a business in different geographies or multiple markets, Management - Management - Network Management, Network Management - Provider connectivity Technology Experience: Desktop Tool - Microsoft PowerPoint, Desktop Tool - TE Microsoft Excel Potential Telework Position: Yes Percent of Travel Required: 10 - 25% EEO Statement: Aetna is an Equal Opportunity, Affirmative Action Employer Benefit Eligibility: Benefit eligibility may vary by 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.

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