Director of Care Management - Aetna Better Health of Louisiana - Remote
About the position The Director of Care Management at Aetna Better Health of Louisiana is responsible for overseeing the strategic and operational business plan for clinical operations. This role involves leading a clinical team, managing care coordination services, and ensuring compliance with regulatory requirements while delivering holistic care to members. The position requires collaboration across various business functions and the ability to synthesize program performance and clinical outcomes to improve overall health care delivery.
Responsibilities
- Oversee the implementation and ongoing execution of the strategic and operational business plan for clinical operations.
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- Lead a clinical team that supports timely Health Risk Screenings, Comprehensive Assessments, and Care Plan development.
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- Develop and manage clinical operations focused on improving clinical and financial outcomes, member engagement, and satisfaction.
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- Serve as a liaison with regulatory and accrediting agencies and other health business units.
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- Formulate and implement strategies for achieving department/unit metrics and provide operational direction.
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- Responsible for cross-functional integration of care management with core business functions.
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- Support quality improvement projects through successful implementation.
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- Develop and participate in presentations and consultations to stakeholders.
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- Direct enhancements to business processes, policies, and infrastructure to improve operational efficiency.
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- Implement and monitor business plans and oversee transitions impacting clinical operations.
Requirements
- Active, current and unrestricted Licensure in state of Louisiana (LCSW, LCPC, RN, LMFT).
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- Nationally recognized case management certification, or ability to obtain within 90 days.
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- 5+ years of clinical practice experience in physical or behavioral healthcare.
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- 5+ years of management or clinical leadership experience.
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- Ability to synthesize program performance and clinical outcomes.
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- 3+ years of experience with personal computer, keyboard navigation, and MS Office Suite applications.
Nice-to-haves
- Master's degree preferred.
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- Experience in Medicaid, insurance, or managed care.
Benefits
- Full range of medical, dental, and vision benefits.
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- 401(k) retirement savings plan.
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- Employee Stock Purchase Plan.
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- Fully-paid term life insurance plan.
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- Short-term and long-term disability benefits.
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- Well-being programs and education assistance.
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- Free development courses.
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- CVS store discount and discount programs with partners.
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- Paid Time Off (PTO) and paid holidays.
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