Senior Director, Clinical Health Services

Aetna   •  

High Point, NC

Industry: Healthcare


11 - 15 years

Posted 48 days ago

This position will develop, influence and implement medical cost strategies as well as business initiatives to improve population health and competitive edge in the market place. Provide leadership and strategy of clinical, coaching and advocacy operations administering medical management and population health. Work with external customers and consultants to deliver best in class healthcare programs to meet their expectations and to support their strategies to improve healthcare of their employees. Develops priorities and sets direction for business segment applying knowledge of business, competitive landscape and regulatory environment. Provide leadership and direction through multiple managers.

Fundamental Components:

  • Develops priorities and sets the strategic direction of business area, applying knowledge of business, competitive landscape and regulatory environment achieved by strategically aligning with enterprise key goals and initiatives.
  • Strategic mindset to evaluate results, redesign, and course correct where opportunities arise.
  • Leads customer facing presentations, meetings and site visits for prospective and existing plan sponsors and can speak to medical trend management.
  • Provides leadership and direction through implementation and go live efforts including pre-implementation and post implementation clinical audits.
  • Accountable for achieving clinical PG’s and driving improved results through the DVS Scorecard, Standard and Incremental ROI’s and Claim Trend Guarantees; ability to understand financial implications (ROI) and articulate and participate in a leadership setting.
  • Provides innovative solutions in response to changing market and enterprise strategies and challenges.

Background Experience:

  • 10+ years leadership experience managing large high performance clinical teams.
  • Exposure to Aetna Clinical Platforms (ATV, ITC, ITCP, etc.)
  • Background or experience in healthcare, customer service and population health.
  • Experienced in working with and integrating 3rd party vendors.
  • Experience in setting strategy and direction and executing on strategy, presenting to executive leadership.
  • Experience with healthcare products and/or program development and delivery.
  • Multiple years proven leadership experience setting strategic direction and influencing change that resulted in quantifiable positive outcomes.

Nursing - Registered Nurse (RN)

Potential Telework Position:

Percent of Travel Required:
25 - 50%

EEO Statement:
Aetna is an Equal Opportunity, Affirmative Action Employer