Aetna Clinical Program Consultant in Houston, Texas
Req ID: 38255BR
A valuable contributor to National Accounts by providing clinical insight, clinical expertise, strategic analysis and advisorship for assigned account teams in supporting plan sponsor relationships. Clinical and utilization report analysis, health promotion and wellness strategy consultation, and customer, consultant and account team support are the cornerstones of this position.
Travel 25% by Air and Car
Preference is for a Candidate to live in TEXAS and living near a major airport.
Review clinical program performance and formulate recommendations for improvement
Analyze a plan sponsors member engagement and utilization experience and identify areas of opportunity (clinical programs)
Be a resource for clinical programs and services and present as needed
Be a resource for industry trends in managing member engagement and medical issues
*Contribute to the value and impact of Aetnas programs through current program enhancement and future program innovations (clinical programs)
Participate in clinical assessments, as needed
Collaborate with medical directors and other clinical areas as needed
Customer facing presentation of content
Preparation of meeting materials in collaboration with account team
Establish credibility and respect with team members
Connect disparate observations to discover integration opportunities; correlations that drive strategy development; cause and effect implications
Proactively demonstrate creative and innovative thinking
Registered Nurse, Social Work degree and/or certified wellness required 3-5 years experience with one or more of the following: Care management, clinical data analytics, understanding of medical trends, formal presentation experience. Knowledge of health promotion and wellness strategy a plus. Knowledge of clinical systems, medical and pharma. treatments required.
The highest level of education desired for candidates in this position is a Bachelor's degree or equivalent experience.
LICENSES AND CERTIFICATIONS
RN or LSW required
Health and Fitness/Wellness Councils of America is desired
Healthcare Management/Case Manager Society of America (CMSA) is desired
Functional - Clinical / Medical/Consultative informatics/1-3 Years
Functional - Clinical / Medical/Sales/1-3 Years
Functional - Clinical / Medical/Concurrent review / discharge planning/
Functional - Clinical / Medical/Disease management/
Technical - Aetna Applications/Aetna Health Information Advantage//End User
General Business/Communicating for Impact/ADVANCED
General Business/Consulting for Solutions/ADVANCED
General Business/Ensuring Project Discipline/ADVANCED
General Business/Demonstrating Business and Industry Acumen
General Business/Maximizing Work Practice
Leadership/Anticipating and Innovating
ADDITIONAL JOB INFORMATION
This is an exciting, fast-paced and rewarding position that allows for the combination on clinical and business experience to positively affect the health of large populations. Working within National Accounts, on a small, close knit team of caring professionals is a perk of this position. The department in which this position resides has a best in class culture with focus on work/life balance and strong teamwork. This job offers the balance of telework and periodic travel to satisfy the human interaction that is sometimes missed when working from home.
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: Management