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Aetna Inc.

Director Clinical Health Services RN Registered Nurse

Aetna Inc. - Detroit, MI

POSITION SUMMARY As the Director of Clinical Health Services you will responsible for the daily operations of care management and utilization management departments. You will have the opportunity to work with three programs and be a part of a very diverse group of managed care backgrounds! You will lead, nurture, report and manage a group of virtual team members. Fundamental Components but not limited to the following: Daily operations of case\/care management, utilization management departments. Complete team will equal roughly 65 staff. Working with a new initiative and focused on driving a productive work at home team. BACKGROUND\/EXPERIENCE 8 years clinical nursing leadership is highly preferred, at least 5 years of leadership is needed managing staff! Ability to synthesize program performance and clinical outcomes Experience managing a large virtual workforce is needed RN preferred or LPN\/LVN with strong leadership is required. CCM Certification is a plus! Masters Degree Preferred Managed care experience is needed! Ability to drive program development, and increase membership through innovative clinical initiatives. Strong computer skills including Power Point and Excel are a must! EDUCATION The highest level of education desired for candidates in this position is a Master's degree. LICENSES AND CERTIFICATIONS Nursing\/Registered Nurse is strongly preffered or LPN\/LVN is required FUNCTIONAL EXPERIENCES Functional - Human Resources\/Generalist\/1-3 Years Functional - Management\/Management - Multifunctional management :> 25 employees\/4-6 Years Functional - Nursing\/Case Management\/4-6 Years TECHNOLOGY EXPERIENCES Technical - Desktop Tools\/Microsoft Outlook\/4-6 Years\/End User ADDITIONAL JOB INFORMATION 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 here to 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: Health Care

6 days 12 hours ago

Aetna Inc.

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Director Clinical Health Services RN Registered Nurse Aetna Inc. - Detroit, MI, United States

   

Location: Detroit, MI

Company Profile:
Aetna Inc. operates as a diversified health care benefits company in the United States. The company operates in three segments: Health Care, Group Insurance, and Large Case Pensions. The Health Care segment provides medical, pharmacy benefit management, dental, behavioral health, and vision plans on an insured basis, and an employer-funded or administrative basis. This segment also provides Medicare and Medicaid products and services, as well as other medical products, such as medical management and data analytics services, medical stop loss insurance, workers' compensation administrative services, and products that provide access to its provider networks in select markets. This segment offers its products and services to multi-site national, mid-sized, and small employers, as well as individual customers. The Group Insurance segment provides life insurance products comprising group term life insurance, voluntary spouse and dependent term life insurance, group universal life, and accidental death and dismemberment insurance; disability insurance products; and long-term care insurance products, which offer benefits to cover the cost of care in private home settings, adult day care, assisted living, or nursing facilities. This segment provides insurance products principally to employers that sponsor its products for the benefit of their employees and their employees’ dependents. The Large Case Pensions segment manages various retirement products, including pension and annuity products for tax-qualified pension plans. The company’s customers include employer groups, individuals, college students, part-time and hourly workers, health plans, health care providers, governmental units, government-sponsored plans, labor groups, and expatriates. Aetna Inc. was founded in 1853 and is headquartered in Hartford, Connecticut.