Aetna TX MCD Program Director TX Star Kids in Austin, Texas
Req ID: 36184BR
Oversees the implementation and on-going execution of the strategic and operational business plan for the business segment's TX Star Kids clinical operations, inbound/outbound call queues, implementation, and/or plan sponsor operations. Coordinates business segment BH policies and procedures in support of financial, operational and service requirements.
-Develop and manage TX Star Kids clinical operations focused on improving clinical and financial outcomes, member engagement and satisfaction -Serve as liaison with regulatory and accrediting agencies and other health business units -Formulate and implement strategy for achieving applicable department/unit metrics and provide operational direction -Serve as technical, professional and business resource (may cross multiple business functions) -Develop and participate in clinical presentations and consultations to existing and prospective customers -Direct/provide enhancements to business processes, policies and infrastructure to improve operational efficiency (may cross multiple business functions) -Participates in internal and external health industry development efforts -Develop, implement, and evaluate policies and procedures, which meet business needs (may cross multiple business functions) -Implements and monitors TX Star Kids business plan and oversees any implementations or business transitions impacting service operations. -Collaborates and partners with other business areas across/within regions or segments and within other centralized corporate areas to ensure all workflow processes and interdependencies are identified and addressed on an on-going basis. -Promote a clear vision aligned with company values and direction; sets specific challenging and achievable objectives and action plans; motivates others to balance customer needs and business success; challenges self and others to look to the future to create quality products, services, and solutions.
8-10 years clinical and program leadership -Start up experience is strongly preferred. -Ability to synthesize program performance and clinical outcome -Previous experience selecting staff, building teams and motivating teams -Demonstrated and exceptional presentation, verbal and written communication skills -Previous managed care, behavioral health and/or health care experience
The highest level of education desired for candidates in this position is a Masters' degree or equivalent experience.
LICENSES AND CERTIFICATIONS one of the following certifications is required:
Mental Health/Licensed Clinical Social Worker
Mental Health/Licensed Master Social Worker (LMSW)
Nursing/Advanced Practice Nurse
ADDITIONAL JOB INFORMATION
Are you ready to join a company that is changing the face of health care across the nation? Aetna Better Health of Texas is looking for people like you who value excellence, integrity, caring and innovation. As an employee, youll join a team dedicated to improving the lives of Texas STAR Kids. Our vision incorporates community-based health care that works. We value diversity. Align your career goals with Aetna Better Health of Texas, and we will support you all the way.
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 here to review the benefits associated with this position.
Job Function: Health Care