RN Clinical Program Consultant (Registered Nurse) East or Central Time Zone - Full-time / Part-time

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.

POSITION SUMMARY

The Clinical Program Consultant works in partnership with existing Aetna account teams to consult with existing Aetna customers and provide their employees with the best possible clinical programs. You will lend support to the customer in the pursuit of effectively managing medical, dental, pharmacy, behavioral health, and disability trend to ensure that the customer is realizing the maximum possible return on their investment in Aetna products and services.

You will collaborate with Aetna National Accounts Field Sales and Service staff to identify customers who may best benefit from Aetna's medical, dental, pharmacy, behavioral health, and disability clinical management programs.

This role will work at home yet will do up to 25% travel as needed for customer visits. The ideal candidate will be located in the Eastern or Central time zones.

Fundamental Components:

* For an assigned case listing, proactively evaluates and analyzes medical, dental, pharmacy, behavioral health, and disability trend drivers and proposes clinical programs and/or improvements to effectively manage these trends

* In collaboration with existing Aetna account teams, consults with clients on trends identified within their employee base and works to tailor the most effective cost management strategy possible

* Seeks to maximize clinical and financial outcomes for customers from the clinical programs and/or improvements recommended

* Identifies and helps rectify clinical program gaps at customers who are utilizing Aetna clinical management programs to ensure best in class clinical management of members

* In collaboration with existing Aetna account teams, establishes and maintains proactive relationships with customers, consultants, vendors, and other external constituents

* Proactively analyzes and presents complex clinical data to customers and consultants in a comprehensive and non-clinical format

* Interfaces with internal clinical, system, and reporting areas to ensure compliance with business requirements and specifications

* Manages to completion a variety of ever changing projects and priorities during the course of the year; effectively mitigates negative outcomes that may arise due the ever changing dynamics of the market and competitive landscape

* Leads clinical/technical aspects of the delivery of multiple, complex projects that align with the customers strategic plan

* Delivers internal Aetna National Accounts training focused on clinical programs, through the preparation and presentation of materials related to medical management

* Serves as a key resource on all clinical programs to all Aetna National Accounts staff

BACKGROUND/EXPERIENCE

* RN degree required

* 5-10 years clinical experience required

* Clinical and financial experience, including data analysis

* Experience as a clinical program manager, an affordability nurses who have managed health care costs and or STAR experience would be ideal!

* Strong Microsoft Office including Excel with pivot table knowledge

* Analytical experience, experience in looking at trends and the ability to provide solutions to stop that trend

* Empathy for the Senior population

EDUCATION

The highest level of education desired for candidates in this position is a Bachelor's degree or equivalent experience.

LICENSES AND CERTIFICATIONS

Nursing/Registered Nurse (RN)

Telework Specifications:

Full-Time Telework (WAH) with up to 25% travel as needed.